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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11 /16/2021 Permit Number:
RECEIVED
Building Permit Application FEB 14'2022
Planning and Development Services . St. Lucie County
Building and Code -Regulation Division Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
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Address:7316 MYSTIC WAY, PORT SAINT LUCIE FL 34986
Property Tax ID #: 3322-620-0028-000-4 Lot No. 23
Site Plan Name: MYSTIC PINES AT THE RESERVE Block No.
Project Name: MARINO RESIDENCE
REMOVE
UNDERLAYMENT AND A NEW TILE ROOFING SYSTEM
Additionalwork to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank —Gas Piping _Shutters -Windows/Doors
_Electric _Plumbing _ Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: 4399 Sq. Ft. of First Floor: N/A
Cost of Construction: $ 31,400.00 Utilities: _ Sewer _ Septic Building Height:15'
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Name DENO MARINO
Name:KARIBAY PORRAS*
Company: JT ROOFING INC
Address:7316 MYSTIC WAY
City: PORT SAINT LUCIE state; FL
Address:4360 SE COMMERCE AVE
Zip Code:34986 Fax:
City: STUART state: FL
Phone No, 772-464-6648
Zip Code:34997 Fax:
E-Mail: BOG EY772CcD-YAHOO. COM
Phone No 772-266-4495
Fill in fee -simple Title Holder on next page (if different
E-Mail INFO@JTROOFINGINC.COM
.from the Owner listed above)
State orcounty License CCC1332040
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value.of HVAC•is $7;500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL_.CONSTRUCTION LIEN LAIN
INFORMATIOW
DESIGNER/ENGINEER:
,4 Not Applicable
MORTGAGE COMPANY:
_ / Not Applicable
Name:
Name:
Y
Address:
Address:
City:
State:
City:
State:
Zip: Phone.
Zip: Phone:
FEE'SIMPLE TITLE HOLDER:
,,4.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 grantirig a, permit -will authorize the permit holder to build the subject structure
which is in conflict with. any applicable Home Owners Association rules, bylaws orand 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 permitapplications are exempt from undergoing a full concurrency review: room additions;
-accessory structures, swimming pools, fences,.walls, signs, screen rooms arid accessory uses to anothernon-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 IINTEND TO OBTAIN FINANCING, CONSULT
"WilM YnUR LENDER �' AN ATTORNEY'.BEFORE RECORDING YOUR 'NOTICE OF COMMENCEMENT."
Signature of Own leeA6e 7/Contractor as Agent for Owner
Signature of Contractor icense Holder
STATE OF FLORI
STATE OFFLORIDA
COUNTY OF . i!Y1Gl.`-A-`
r,
COUNTY OFhp,
The forgoing instrument was acknowledged'before -me
this'-w%yof N Oy ,'20� by
The forgoing instru e t wa acknowledged before me
this �day.of .20 by
�prrc�S.
v � .
me of person rnakind statement:.
Name of person mak_ g statement:
rsonally Known •OR Produced Identification
P.eisonally Known _ : .. OR Produced, Identification.
pe of•ldenti` cation
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Type.of Identification
Produced
oduced Yl yx. l`� 9
Sig re of Notary.Public- State ofr�Florida ) .
(Sign ure of Notary. Public- Florida ;)
ommission No. �. l�aa Z�9(Seal)
[�State
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Commission No: -15 ocp�g�(Seal)
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