HomeMy WebLinkAboutReRoofApplication6705santaClaraAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: D, 120-2 °lam
Permit Number:
Pr LL Co IJ, e fi V,
Planning and Development Services Building Permit Application
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Commercial Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 CRDG Funding --__
PERMIT APPLICATION FOR: �,� ���
PROPOSED IMPROVEMENT LOCATInNv
Address: 0�D(iS �...
Property Tax ID#: 1 3(aLG II —0 3 : _00'i 3
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK..
New Electrical Meter Second Electric
CONSTRUCTION INFORMATION:
//
(Affidavit required)
Lot No.
Block No.
Additional work to be performed under this permit —check all that apply:
_,Mechanical Gas Tank
— Gas Piping — Shutters Windows/Doors
_ Electric — Plumbing— _Pond
_ Sprinklers Generator
Total Sq. Ft of Construction: — Roof pitch
Cost of Construction:
$ � Sq. Ft. of First Floor: - L� 'au! L
OWNER/LESSEE: Utilities: —Sewer —Septic Building Height:_
N a me-yn b2 C I o n!!� W
Address: (070 - jean
City: r-A- Vi t° r L
s
Zip Code: / Fax: Stater
Phone No. 7
Mail: e ,rV—A,
E-
Fill in fee simple it Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: U � n
Company:;� "i'?L)it--5
Addrd s.
City: JAI-� 191&' e d'
State:
Zip Code: 3_9'!� L/—,:; Fax:
Phone No - BJ —,�rV --,'/
E-Mail: �04 �= c t3
State or County License l3`2'
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
Name:
MORTGAGE COMPANY:
Address:
Name:
City:
Zip: Phone State: _
Address.
City.
FEE SIMPLE TITLE HOLDER: /
Applicable
Zip: —__ Phone:
Name: _Not
BONDING COMPANY':
Address:
Name:
City:
Address:
Zip: -' Phone:
City:
Zip: Phone:
,.;;`Not Applicable
Not Applicable
u NER/ 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 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 a I .
In consideration of the granting of this requested permit, I do hereby agree that I will, in all res ects y pp y in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
p ,perform the work
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 consult
improvements to your property. A Notice of Commencement must be recorded in the public records o
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing,
with lender or an attorne before commencingwork or recordingour Notice of Commencement. f St.
SignatureoContractor - or - Owner Builder as applicable
STATE OF FLORIDAr-,
COUNTY OF
Sworn to (or affirmed and subscribed before me of !�
this i - day of eb 20 ,2 by Physical Presence or Online Notarization
Name of person making statement.
Personally Known OR Produced Identification
Type of I tification Produced
(Signature of Notary Public- State of Florida)
Commission No. /1#0-327?ts eal)
?OP
Notary Public State of Flonda
Carmen M Quinones
My Corrmmisaion HH 093277
Expires 02/15/2025
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW
DATE REVIEW REVIEW REVIEW
RECEIVED