HomeMy WebLinkAboutBuilding Permit Application All APP,6CABLE INFO,MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:';
,,..W-4
Building Permit Application owns.'
Planning!and.Development Services Pe
euildingldrid iCb&Regulatign Division Commercial Residential
2300,1Yirginia Avenue,`kort Pierce FL 34982 !i
I
'.Phone (772)462-1553 Fax: (772)462-1578 l
PERMItAPPLICATION FOR: RE-ROOF
PROPOSED,IMPROVEMENTIOCATION: ;
Address" „"i . 7101 PALOMAR PKVVY, FT. PIERCE ii
1301-615-0236-000-8
Property,Ta ,ID#:, 'Lot No.
7101 Palomar I:
Site P,I Ian;Name: Block No,
P`Irojeet:lN'ame: 7101 Palomar
DES A'I.i�ED.-DESCRIPTION-OF WORK
:
ReT'l of -'Remove Shingles[ Install Standing Seam Metal
Inte; rty'Metal,LLC - FL 29444-R2
wens omm. - ltaniuin: n er aymentFL,116 2 r
di
New Electrical Meier.';!, Second Electrical Meter (Affidavit''required) r'
CONSTRUCTIQN 1NFORMATION:
Additional work to be performed under this permit—check all that apply: r
Mechanical Gas Tank Gas Piping Shutters _Windows/Doors Pond !
EI'e'ctric _Plumbing _Sprinklers —Generator XXXRoof Pitch
Total1Sq.`�,tbf Construction: Sq. Ft. of First Floor:
12000
Ctiof Construction:$ Utilities: —Sewer _Septic Building Height: {',
OWNER/LESSEE CONTRACTOR
G a i anova
Name^ v'f ✓� .e �y.',., c,,✓ Name: y
s Addres:1r',. Company:
Villan6Va'Construction Inc.
city, �z� a ei L4,' State: r-7 : Address: 2908 Oleander Blvd.
p'�ocie Y (0 a Fax: City: Ft. Pierce;'FL State FF}i';F
Phoie;No.`r Zip Code: 34982 Fax:
E- 772 940 ,6654'
M'a'il::'�i• '`��� � Phone No
yi
Fill in fee;sim raple Title Holder on next page(if different E-Mail Wian@ao .com
from the Owner listed above) State or County License CCC 1327240
CRC 1327518
If value;of construction pis 2500 or more,�a RECORDED Notice of Commencement is required.d: i
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 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 per 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
s
Signat a of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFST.LUCIE COUNTY OF ST.LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this,±Cday of —� ✓ . 202-1 by this day of 20_ by
Name of person making statement. Name of person making statement.
J
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification / Type of Identification
Produced Produced
(Signature of Notary Public- to a of Florida ) nature of Notary Public-State of Florida)
����y pV/,� H F, ITH E R B to F
ORD
Commission No. �� ���� public-State of FI ri mission No. (Seal)
/ `` Commission 4!HH 218 10
My Commission Expires
mu•
REVIEWS FRONT PERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19