HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
LY UI
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Re -roof
PROPOSED IMPROVEMENT LOCATION:
2
Address: 5746 Clydesdale LN PORT SAINT LUCIE, FL 34987
Property Tax ID #: 3309-605-0028-000-6 Lot No. 25
Site Plan Name: GRIFFIN Block No. A
Project Name:
DETAILED DESCRIPTION OF WORK:
ocnnnvF Fx-nnirr RnnE r'nVP:R / RE -NAIL ALL DECK UP TO CODE / INSTALL NEW PEEL & STICK UNDERLAYMENT
Install 1" nail strip metal roof / 24 gauge
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Mechanical Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing
(Affidavit required)
Sprinklers _ Generator
Windows/Doors _ Pond
X Roof 5/12 Pitch
Total Sq. Ft of Construction: 4856 SQ FT Sq. Ft. of First Floor: 4856 SQ FT
Cost of Construction: $ 37,900.00 Utilities: —sewer _ Septic Building Height: 12'
OWNER/LESSEE:
CONTRACTOR:
Name ROGER B GRIFFIN
Name: MAURICIO ORELLANA
Address: 5746 CLYDESDALE LANE
Company: ONE CONSTRUCTION & ROOFING CONTRACTORS, INC
Address: 2139 sw Conant avenue
City: PORT ST I UC;IF State: _EL
Zip Code: 34987 Fax: N/A
Phone No. 7797HR-4539
City: PORT ST LUCIE State: FL
Zip Code: 34982 Fax: N/A
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 oneconstructionservicesa-yahoo.com
State or County License CCC-1330623
if value of construction is z5uu or more, a Ktf.UKUCU NUIIGC V1 %.VIIIltwn C111=1 — Ic4.. .
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:
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 granting a permit will authorize the permit holder to build the subject structure
is in with any applicable Home Owners Association rules, bylaws or and covenants'that may restrict or prohibit such
which conflict
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 lobsite 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.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA COUNTY OF �S•_ e
Sworn tamer affirmed) and subscribed before me of L'_P"hysical Presence or Online Notarization
this day of 1>0-enAf0;�\ by
�� \
Name of person making statement.
Identification
Personally Known OR Produced
Type of Identification Fro ed
,,.-.
(Signature of Notary Public- State of Florida )
Commission No. .a<aYP�e,•.: PAULEMBLAIR-ALEXANDER
l
` (Seal) ;x Notary Public
- State or Florida
p �q Commission R GG 987031
My Comm. Expires Sep 6, 2024
Bonded through National Notary Assn.
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Rev 5 2 21