HomeMy WebLinkAboutBuilding Permit App - signed by Contractor All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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
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PERMIT APPLICATION FOR: ROOFING PERMIT
` � 1C�rN _ R
Address: 884 SE SOLAZ AVE PORT ST, LUCIE FLORIDA 34983
Property Tax ID tt: 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
RE- ROOF ASPHALT SHINGLES
New Electrical Meter Second Electrical Meter (Affidavit required)
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 Construction:S 12,970.00 Utilities: _Sewer _Septic Building Height:
1.. �Yti r[ •t; Yvti -
Name �' Name: Leo4z&o
Address: L,) 1 Company.
City:'1 i ju t� :�H, State7ji. Address: /
Zip Code: Fax: City: olliml
Stater
Phone No�j 7�,�?� U 9 q. E- Zip Code: Fax:
Mail: Phone No
Fill in fee simple Title Holder an next page(if different E-Mai l
from the Owner listed above) tat or i1ounty License
If value of construction is 2500 or more,a RECORDED Notice of Commencement Is required.
if value of HAVC Is 57,SOO or more,a RECORDED Notice of Commencement Is required.
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 ggrantin 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 le deter or
rr)an attorneybefore commencingwork or recordingour Notice of Commencement.
Signature o Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTYOF St. lucie County
Sworn to(or affirmed)and subscribed before me of X Physical Presence or_Online Notarization
this-4thdayof November 2021 by
Name of person m ' g statement.
Personally Kn n OR Produced Identification
Ty I on Produced
(S' nature of Notary Public-State of Florida)
Commission No.� /?S_4o� (Seal) p"t" MARy PINEIRO
Notery pablie.5sete or Florida
.� Commission k GG 105461
My Comm.Expires May 11.2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 5/20/21