HomeMy WebLinkAboutGarcia re roof app SUPPLEMENTAL CONSTRUCTION LIEN 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 Branting a permit will authorize the permit holder to build the subject structure
which conflicts with anV applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Homeowners 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 I der or an attorney before commencing work or recording our Notice of Commencement.
),LZ, � L,�-Cff
SignatrFLORIDA
Ow L ee/Contr ctor as Agent for Owner
STAT ( r /+` 1n
COUNTYOF � A 1 '
Sworn to(or affirmed)and subscribed before me of Physical Presence or_Online Notarization
this J1r2layof_GC�GfJ?Y .20 by
Jeff e�� C
Name of person making statement.
Personally Known X OR Produced Identification
Typ dentlfication Produ
(Signature of NotartVublicJState of F rida)
rr!!
,�t�itr HANOY HAGERHORg7
Commission No. __7%'4eal) Notary Public
-,. State of Florida
= ComM#HH167992
F 19� EXPIr"8/23/2025
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: , Permit Number:
9�o UYCM
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: CJ r—
PROPOSED IMPROVEMENT LOCATION:
Address: ACA W-S
Property Tax ID#: ;- Sao SO 0a Q 1 O q Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
C), U e u v - I 1 CC T t J 1 K l (e
ACa► lwlrj�=gcl circa-�c'l, �QCQ S� l � actl.� �� unc�er(c� I
L' S Ird ricJ I im semJ m
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
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 Pitch
Total Sq. Ft of Construction: -2,00 , Sq. Ft.of First Floor: qg S 7-
Cost of Construction: $ [y ' Utilities: -Sewer _Septic Building Height
OWNER/LESSEE: CONTRACTOR:
Name i'\ ' V1 qavctcl Name: }Q V ty �CS�O
Address: 28UI S 10CCS0% 11- n Q G S le Company: LSr fC0- Ctrs+- (? Xil( (5
1-6 City: f -�- 9k-et (�v- State: Address: Q61L( S (U 55 A
Zip Code: �y( q 'd-'S Fax: City: 1V M C t I-" State:rL
Phone No. Zip Code: :�`d qq6 Fax:
E-Mail: Phone No 7 - S- 1 G_► 5
Fill in fee simple Title Holder on next page ( if different E-Mail
from the Owner listed above) State or County LicenseTA
If value of construction is 2100 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.