HomeMy WebLinkAboutBuilding Permit Application s `
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/25/17 RECEIVED SEPe"t284-tuber:
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Building Permit Application
Planning and Development Services
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— m��
PROPOSED IMPROVEMENT LOCATION.:
Address: 8264 SANDPINE CIRCLE PORT SAINT LUCIE FL 34952
Legal Description: LAKE LUCIE ESTATES PLAT NO.ONE LOT 23(OR 2929-2589)
Property Tax ID#: 3426-703-0037-000-3 I Lot No.23
Site Plan Name: ONE2 Block No.
Project Name: ONE 2
Setbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
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DETAILED DESCRIPTION OF WORK: ,: l
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REMOVE EXISTING ROOF COVER
INSTALL NEW PEEL & STICK UNDERLAYMENT
INSTALL NEW METAL ROOD 1" CLIPLESS NAIL STRIP /26 GA
'CONSTRUCTION'I'NFORMATION.
Additional work to be nertormed under this permit—check all that app y:
LHVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric 0 Plumbing Sprinklers E]Generator Roof /12 Roof pitch
Total Sq. Ft of Construction: 3341 S . Ft.of First Floor: 3341
Cost of Construction:$ 19,000 Utilities: Sewer Septic Bu I i(ding Height: 8.
OWNER/LESSEE: CONTRACTOR. .
Name HAZEL A ANTIOLA Name: MAURICIO ORELLANA
Address:8264 SANDPINE CIRCLE Company: ONE CONSTRUCTION&ROOFING CONTRACTORS
City: PORT SAINT LUCIE State:FL Address: 2766 SW ESGARCE St
Zip Code: 34949 Fax: N/A City: PORT SAINT LUCIE State: FL
Phone No.772-835-7887 Zip Code: 34953 iFax: N/A
E-MaiI:N/A Phone No. 772-519-2449 11
Fill in fee simple Title Holder on next page(if different E-Mail: oneconstructionservicesdyahoo.com
from the Owner listed above) State or County License: CCC-1330623
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENT AL.CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:HAZEL A ANTIOLA N a m e:MAURICIO ORELLANA
Address:8264 SANDPINE CIRCLE PORT SAINT LUCIE FL 34952 Address: 8264 SANDPINE CIRCLE
City: PORT SAINT LUCIE ate: City: PORT SAINT LUCIE State:
Zip: Phone Zip: Phone:
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FEE SIMPLE TITLE HO R: _Not Applicable BONDING COMPA . _Not Applicable
Name: Name:
Address:2766S GARCEST Address: .I
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 restriction's 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:too 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 financing, consult with lender or all' attorney before
commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �al -- G--,<e COUNTY OF 5 \ , L1��\
The forg=g instrum t was cknowledged before me The fore instru nt wa ackn� wledged before me
this day of 20�by this�5 day of 20by
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Name of person making statement Name of person making statement
Personally Known�/OR Produced Identification Personally Known ''--OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Nota C—t—nf-FlariQ of Notary Public-State of Florida
111111111,,,
°ot'��'`'a's' PAULET( BygIR-ALEXANDER Commission No ;s1°�e�•., ! PAULETTEI�ALEXANDER
Commission No. ? �= * :;Notary Public-State of Florida
Notary Public-State of Florida
o. Commission#FF 995699 ` �' Commission#FF 995699
REVIEWS FRONT ZONING PLANS V,EGE A E N R
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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