HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO. BE ACCEPTED
Date
Permit Number:
RECEVED
Building Permit Application NOV 14' 2017
Planning and Development Services PERMITTING
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Manuff. Home
PERMIT APPLICATION FOR: Roof P -? C f CtiL
PROPOSED IMPROVEMENT LOCATION:
.Address: 1 Nbestra Calle Ln. Port St Lucie, FI 34952
Legal Description:
Property Tax ID #:
Site Plan Name: Roof Over
Project Name: Roof Over
Setbacks Front 31.67 Back: 30.00
Right Side: 22.67 Left Side: 27.00
Lot No. 2248
Block No.
DETAILED DESCRIPTION OF WORK:
Install Metal Roof System over existing shingles with 1 x 4 added for addition screw downs.
& C) 31 LE p-9 r-1-r
CONSTRUCTION INFORMATION:
E1HVAC Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction: 1,620.00
Cost of Construction: $= 2,550. c,.n
mis permit — cnecK a
❑Gas Piping
❑ Sprinklers
❑ Shutters ❑. Windows/Doors
11 Generator W1 Roof 3/12 Roof pitch
S Ft. of First Floor: _
Utilities: Lr J Sewer El Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Michael Cerny
Name:
Address: 1 Nuestra Calle Ln
Company:
Address:
City. Port St Lucie State: FI
Zip Code: 34952 Fax:
City: State:
Phone No. 772 528-3809
Zip Code: Fax:
E-Mail: mcerny76@comcast.net
Phone No.
Fill in fee simple Title Holder on next page (if different
E-Mail:
from the Owner listed above)
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CC
DESIGNER/ENGINEER:
Name:_
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
LIEN LAW INFORMATION:
Not Applicable
State:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
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 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 attorney before
commencing work or recording your Notice of Commencement.
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Signature of Owner/ Lessee/Contractor gent for O 't1LL N ignature of Contractor/License Holder
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STATE OF FLORIDA
AFL IL
��' ' TATE OF FLORIDA
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COUNTY OF
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The forgoing instrument Vias acknowledged before m
O ZEE 2
< }w The forgoing instrument was acknowledged before me
this Ja- day of 20 by
m
this day of 120 by
Name of person making sta ment
-_ Name of person making statement
Personally Known OR Produced Identificatio
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"t"fir
Personally Known OR Produced Identification
Type of Id if' tion )
- I �-
Type of Identification
Produced i- CL ✓` L
Produced
,K
(Signature of No ry Public- State of Florida U
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
,�� t
RECEIVED
DATE
TA
TAGS
COMPLETED
tev. 8/2/17
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