HomeMy WebLinkAboutBuilding Permit Application01. LuuIG %_-Vur ny
Housing Department
All APPLICABLE INFO MUSfQIQLrOR APPLICATION TO BE_ACCEPTED
Date: AFFORDABLE ATTAINABL&it Number:
__JWRKFORCE HOUSING
"_v 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: Re -roof permit
PROPOSED IMPROVEMENT LOCATION:
X
Address: 3609 Avenue 0 Fort Pierce FI 34947
Property Tax ID #: 2405-601-0319-000-3 Lot No. 14
Site Plan Name: Washington Block No. 17
Project Name: Washington
DETAILED DESCRIPTION OF WORK:
REMOVE EXTING ROOF COVER / RE -NAIL ALL DECK UP TO CODE / INSTALL NEW PEEL & STICK UNDERLAYMENT
Install New Tamko / Heritage shingle
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping — Shutters _ Windows/Doors Pond
_ Electric _ Plumbing — Sprinklers — Generator x Roof 4/12 Pitch
Total Sq. Ft of Construction: 1,170 sq. ft. Sq. Ft. of First Floor: 1,170 sq. ft.
8,000.00 Utilities: Sewer ht: 12'
Cost of Construction: $ — —Septic Building Heig
OWNER/LESSEE:
CONTRACTOR:
Name Robbie Washington
Name:Mauricio Orellana
Address: 3906 Avenue O
Company:One construction & Roofing contractors
City: Fort Pierce State: FL
Zip Code: 34947 Fax: NIA
Phone No. 772-769-3456
Address: 2139 sw Conant avenue
City: PORT SAINT LUCIE State: Fl
Zip Code: 34953 - Fax: N/A
Phone No 772240-9497
E-Mail: N/A
E-Mail oneconstructionservices@yahoo.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License CCC-1330623
If value of construction is 2500 or more, a KtLU KULU nioiice or 1.UF11F11tlnl Cn ICI IL lD I =yuu
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
. A ,..� . --_— .
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name:
Name: —
Address:
Address:
State:
City: State:
City:
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
is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
which
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
A Notice Commencement must be recorded in the public records of St.
improvements to your property. of
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.
CtOA�_�
� L<
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA�i 1
COUNTY OF
/Physical
Sworn to (or affirmed) and subscribed before me of Presence or Online Notarization
this 15 day of 20)J by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced a�ONNIE•C,L��`�i��
29,
(Signature of Notary Public- State of Florida)
(� y 2 #GG 974297
Commission No. I �9 (Seal) �o:;A
�blic under.,. CT
STATE
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
COUNTER
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5 2 21