HomeMy WebLinkAboutvan loan permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATiON TO BE ACCEPTED
Date: ,- Permit Number:
911a LUCf
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: Reroof _
PRQPSqil'mPt'�ICT LOCATIiI�i:
Address: 1123 Nettles Blvd
Property Tax lD #: 4502-501-1310-000-4 Lot No.
Site Plan Name: Van Loan Block No.
Project Name:
Van Loan
DEVILED ESC IP T ICNI'CF MO i a
Remove existing roof system down to decking, renail to code,
install high temp underlayment, install new 5v 26g metal roof system to code
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 aRoof 4/12 Pitch
Total Sq. Ft of Construction: tv- Sq. Ft. of First Floor: 1 G
Cost of Construction: $ Utilities: —Sewer _ Septic Building Height: 25
OWNERji F E .
CONTRACTOR:
Name E Thomas Van Loan _-
Name: Richard Colletti
Company: Leakbusters Roof Repair
Address: 1123 Nettles Blvd
City: Jensen Beach State: FL
Address: 3420 25 h Street W
city: Vero Beach FL State:
Zip code: 34957 Fax:
Phone No. E-
Zip Code: 32968 Fax:
Mail:
Phone No 7723328450
E-Mail richiecolletti@gmaii.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License CCC 1330976 21673
If value of construction is 2500 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.
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DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE MOLDER:
Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City
City:
Zip: Phone:
Zip: Phone:
OWNERf 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 conflicts with any, 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 lender or an attorney before commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA'
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COUNTY OF . I ;l
Swor o (or bef Physical Presence Notarization
affir and subscribed r me
this day of 20by
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Name of person making ,atement.
Personally Known OR Produced Identification
Type of Identification Produced
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(signature of otary Public- State of Florida)
S H E L L I L E ST E R ROBS
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Commission No. HY} ' t (Seal)
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•, Commission # GG 194634
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March 11, 2022
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