HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED [�
Date: Permit Number:
Building Permit Application APR ? 7 2017
Planning and Development Services St. Lucie Count;, FL
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 765 E Prima Vistsa Blvd.
Legal Description: River Park- Unit 3- Blk 25 Lot 13 (Map 34/22S)(OR 3689-745)
Property Tax ID#: 3419-515-0152-000-6 Lot No. 13
Site Plan Name: Block No. 25
Project Name:
Setbacks Front Back: Right Side: Left Side:
i
DETAILED DESCRIPTION OF WORK:
reroof 13 squares of flat roof(TPO 60-mil FL 5293.1)
CONSTRUCTION INFORMATION:
Additional work to be r)ertormed under this permit—cleck all apply:
nHVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
❑Electric ❑ Plumbing Sprinklers Generator Roof <2/12 Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 8361.00 Utilities:In Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Jessica Seegoolam Name: Raquel Swanner
Address:765 E Prima Vista Blvd. Company: The Home Depot
City: Port St Lucie State:FL Address: 6500 NW 12th Ave. Ste 110
Zip Code: 34952 Fax: City: Fort Lauderdale State:FL
Phone No. Zip Code: 33309 Fax:
E-Mail: Phone No. 754-224-2010
Fill in fee simple Title Holder on next page( if different E-Mail: Jonathon.thomas@expeditepermit.com
from the Owner listed above) State or County License: CCC1331113
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
F
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:
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financin suit with lender or an attorne before
com work or re in uY Notice of Comm cement.
-- � S
Signatu a �FLOIDA
ee/ ntractor as Agent for Ow Signat ntra lc se Holder
STATE O STAT F FLORIDA
COUNTY OF ;E;. wcke COUNTY OF Si• lcaG�F
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Z�p day of X-P1 L 20 ii—t by this 24o day of A?kG 20'%1 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. ommission No.
.•iMi`.r�:i% TIMOTHY R.02MALLEY
TIMOTHY 1R.O'MALLEY *�' t: MY COMMISSION#FF 042794
EXPIREC:August 7,2017 :; Y_F ` gpnded Thru Notary Public Underwriters
Revised 07/15/2014 I�'••P;,,;4 Bonded Thru Notary Public Underwriters Y
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE 1
INITIALS
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