HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
i�
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Remove and replace existing roof cover
PROPOSED IMPROVEMENT LOCATION:
X
Address: 6804 Shelley Terrace Port Saint Lucie FI 34952
Property Tax ID #: 3415-705-0007-000-6 Lot No. 6
Site Plan Name: Palumbo Block No. 1
Project Name:
Palumbo
DETAILED DESCRIPTION OF WORK: I
Remove and replace existing roof cover
Install peel & stick underlayment
Install New Tamko / Heritage shingle
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical
— Electric
Gas Tank
_ Plumbing
Total Sq. Ft of Construction: 2,996 SF
Cost of Construction: $ 15,700.00
Gas Piping
_ Sprinklers
Shutters Windows/Doors _ Pond
_ Generator
Sq. Ft. of First Floor
X Roof 5/12 Pitch
2,996 SF
Utilities: —Sewer _Septic
Building Height: 121
OWNER/LESSEE:
CONTRACTOR:
Name Shawn George Sabia
Name: Mauricio Orellana
Address: 6804 Shelley Terrace
Company:ONE CONSTRUCTION & ROOFING CONTRACTORS, INC
Address: 2139 SW Conant Avenue
City: PORT SAINT LUCIE State: FL
Zip Code: 34952 Fax: N/A
Phone No. 772-240-9497
City: PORT SAINT LUCIE State: FI
Zip Code: 34953 Fax: N/A
Phone N0772-240-9497
E-Mail: N/A
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail oneconstructionservices@yahoo.com
State or County License CCC-1330623
If value of construction is 2500 or more, a Ktcuttutu Nonce or wmmencernenL ,ZO , cyuu vu.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION MEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Sworn to (or affir ed) and subscribed before me ofyhPhysical Presence or Online Notarization
this A day of i� \ 20 by
Name of person making statement.
Personally Known �� OR Produced Identification
Type of tification Produced
KL���
—
(Signature o Notaary Public- State of Florida )
Commission No. _v_�Cj� (Seal *��PU.. PAULETTE BIAIR•ALEXANDER
Notary Public
. State of Florida
Commission # GG 987031
off° My Comm, Expires Sep b, 2024
Bonded through National Notary Assn.
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