HomeMy WebLinkAboutPermit Appl for 6816 Shelley TerrAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
t LU
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
PERMIT APPLICATION FOR: Re -roof permit
PROPOSED IMPROVEMENT LOCATION:
Address: 6816 Shelley Terrace Port st Lucie FI 34952
Property Tax ID #: 3415-705-0010-000-0 Lot No. 1
Site Plan Name: Wilson Block No. 9
Project Name: Wilson
DETAILED DESCRIPTION OF WORK:
REMOVE EXTING ROOF COVER / RE -NAIL ALL DECK UP TO CODE / INSTALL NEW PEEL & STICK UNDERLAYMENT
INSTALL NEW SHINGLE ROOF / TAMKO / HERITAGE
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(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 5/12 Pitch
Total Sq. Ft of Construction: 3.807 sq ft Sq. Ft. of First Floor: 3,807 sq ft
16,000.00 Utilities: Sewer
Cost of Construction: $ — —Septic Building Height: 12'
OWNER/LESSEE:
CONTRACTOR:
Name David Wilson
Name: Mauricio Orellana
Address: 6816 Shelley Terrace
Company: One construction & Roofing contractors
City: PORT SAINT LUCIE State: FL
Zip Code: 34952 Fax: N/A
Phone No. 772-345-0456
Address: 2139 sw Conant avenue
City: PORT SAINT LUCIE State: FL
Zip Code: 34953 Fax: NIA
Phone No 772-240-9497
E-Mail: N/A
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail oneconstructionservices@yahoo.com
State or County License CCC-1330623
If value of construction is Z5uu or more, a KtLUKutu sMotice v1 wrn1eocin.Cn1enL a 4"
if value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name:
Name: —
Address:
Address:
City: State:
Zip: Phone
City: State:
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 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 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.
AI -" 'r,
4ak_U44x��
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF ! \
Sworn to (or affirmed) and subscribed before me ofsical Presence or Online Notarization
this _Cdayof rAr,� 20'�by
Name of person making statement.
Personally Known G----O--R Produced Identification
Type of Identifi Produced
(Signature of Notary Public- State of Florida )
V
Commission No. V kT�J (Seal)
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5 20 1