HomeMy WebLinkAboutBuilding Permit Application t,
ALL APPLICABLE FO M ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 07 . Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end if line
PR }POSD iVIIIOVEMENTLOCATiON Ilf x3 T
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Address: 19 Majestic Way Hutchinson Island
Legal Description: Queens Cove-Unit 1 -Blk 17 Lot N (or 1361-.356)
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Property Tax ID#: 1414-701-0169-000-8 Lot NO,Lol N(or 1361-356)
Site Plan Name: n/a Block No. 17
Project Name: n/a i.
Setbacks Front Back: Right Side: Left Side:
DETACLLI� DESC�RIrvPTION QE WORK x� 3x��` �Eill � 'I
Remove existing shingles and replace with Metal Roof
'Ct�5TRUCTI ?N INFOR(1LTIC;"N d f ...} . ': .s
)bona'work to be nertormed under this permit—check all that apply:
❑HVAC Gas Tank Gas Piping Shutters Windows/Doors
Electric El Plumbing []Sprinklers Generator Roof 5�12 Roof pitch
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Total Sq. Ft of Construction: 3800 Sn
32,000 of First Floor:
Cost of Construction:$ Utilities: _Sewer❑Septic Building Height:
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OWNER%LES5E1= NT�tACI`ORP `��
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Name Barry Scuthorpe Name: William Lasky Jr
Address:19 Majestic Way Company: Atlantic Roofing II of*ro Beach Inc.
City: Hutchinson Island State:Fl Address: 4020 43rd Ave
Zip Code: 34949 Fax:nia City: Vero Beach i State:FI
Phone No.n1a Zip Code: 32960 IFax: 772-257-5740
E-Mail:nia Phone No. 772-492-8493
Fill in fee simple Title Holder on next page (if different E-Mail: wljatr@aol.com
from the Owner listed above) State or County License: CCC1326188
If value of construction is$2500 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: I 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:
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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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorne efor
commencin work or record in u rN otce of Commencement.
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Sign ture of Owner/Lessee/Contra r as Agent for Owner Signs ure of Contractor/License Holder
STATE OF FLOMDA STATE OF FLORI .A
COUNTY OF�AA� IV� COUNTY OF�i1�'CA&'L -4� 1/fP/L—
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The forgping instru ent was acknowledged before me The f rgoing instrum�n as ackrii w1e20��beefore me
this,day of 2011"7 by this�day of /� _ by
Name of perso maki g statement V OWK)e-- Name of person maki g statement
Personally Known 0 Produced Identification Personally Known �✓ OR Produced Identification
Type of Identification Type of Identification
Produced 'Produced
Sign re of Notary Public-State of Florida) (Si ature f Notary Public-State of Florida)
Commission No. �� 1 7� (Seal) Commission No. f ? (Seal)
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17