HomeMy WebLinkAboutPA01. PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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: 1772)462-1578 CBDGFunding
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PERMIT APPLICATION FOR: ROOFING PERMIT
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Address: 884 SE SOLAZ AVE PORT ST. 4UCIE FLORIDA 34983
Property Tax ID k: 3419-550-0020-000/1 Lot No.9
Site Plan Name: RIVER PARK UNIT 7 MAP 34/28S Block No. 63
Project Name: WAVE RIDER PROPERTIES LLC e
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RE- ROOF ASPHALT SHINGLES
New Electrical Meter second Electrical Meter (Affidavit required)
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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 4112 Pitch
Total Sq. Ft of Construction: 2400 Sq. Ft. of First Floor: 2400
Cost of Constru
ction: $ 12,970.00 Utilities: _Sewer _Septic Building Height:
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Name zri�> "SC_?nPS _ • 1 Name: d
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Address: 5Q SW cS1P W Company. Q
City:2 i t j a ri � . I—AWMIMIEZ-314- State.-] Address: /
Zip Code; Fax: City: Kj1dM7 State: 1�71 �
Phone No(72 L) (n'7_� S
-U9y• E- Zip Code: Fax:
Mail: vim* Phone No
Fill in fee simple Title Holder on next page (if different I E-Mail
from the Owner listed above) fate or Lunty License /
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 HOLDER: — Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address; Address:
City: r City:
Zip: Phone: r 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 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 our Notice of Commencement.
nature. ner/LesseeKontractor as Agent for Owner
STATE OF FLORIDA �.-P
COUNTY OF /fu(71 Q�
Sworn to(or affirmed) and subscribed before me of Physical Presence or Online Notarization
this f C' day of Od*ob F2 ,20,?( by
Name of person making statement.
Personally Known V"Ir OR Produced Identification
Type of Identification Produced
(Signature of Notary Public-State of Florida) LNNtr
a A icia Medina .+ti%v Alicia Medina
Commission No. �i (Sea I) ;omm.AHH116362 Comm.kHH116362
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_xpires:April 11, 2025
�-�•s,:�.`R' E> es:April 11, 2025
1�„? anded Thru Aaron Notary 's^; Bonded Thru Aaron Notary
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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