HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
0
Building Permit Application
Pl ices
Building and code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fart Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 2221 NW SEAGRASS DR PALM CITY, FL 34990
Property Tax[D#: 4426-805-0009-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
REROOF TILE TO TILE WITH PEEL AND STICK UNDERLAYMENT
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical Gas Tank _Gas Piping _Shutters ^�W/indows/Doors _Pond
Electric _Plumbing `Sprinklers _Generator /� Roof 6/12 Pitch
Total Sq. Ft of Construction: 3300 Sq. Ft. of First Floor:
Cost of Construction:$ 33,000.00 Utilities: `Sewer _Septic Building Height: 11 FT
OWNER/LESSEE: CONTRACTOR:
Name JAMES& ELLEN HARRIS Name: Frank Leo
Address: 2221 NW SEAGRASS DR Company: Leo Roofing and Construction
City: PALM CITY State: FL Address: 3804 Burns Road Ste D
Zip Code: 34990 Fax: City: Palm Beach Gardens State: FL
Phone No. 978-579-1812 E- Zip Code: 33410 Fax:
Mail: E LLEN.HARRI&cDCOM CAST.NET Phone No 561-935-4979
Fill in fee simple Title Holder on next page (if different E-Mail adrienne@leorc.com
from the Owner listed above) State or County License CCC 1328402
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.
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 TITLEHOLDER: _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 Brantin6 a permit will authorize the permit holder to build the subject structure
which conflicts with an�applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consul t 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 1 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.
Sig ure of Contractor-or-Owner Builder as applicable
STqE OF FLIONTY OF 11¢IILh
Sworn to to Yaffi ed)and d subscribed be �e of Physical Presence or Online Notarization
this2fga of�bOA . ,2 b
Jaiy i-n go-&JIl ,o
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced
(Signature of Notary Public-State of Florida)
Commission No. "V4 p_553Q eal) 71'r Noun Pv11.Sues d Ewan.
Adrienne Theeck
l My Cm+Mn HH 058304
E. "Z'0rzerz021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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