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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u
Date: October%2017 Permit Number:I1 16 _G 1
RECEP.,111T 092017
Building Permit Application
Planning and Development Services
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Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xX
PERMIT APPLICATION FOR: Roof - S�', 1� a- k
PROPOSED IMPROVEMENT LOCATIO,N:.
Address: 10701 South Ocean Drive, Lot #774, Jensen Beach, FL 34957
Legal Description: Venture Out - Section C - Lot #175 (OR 372-2269-838-2764)
Property Tax ID #: 4511-805-0175-000-9 Lot No. 175
Site Plan Name: Block No.
Project Name: Rundell
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRI,PTIO,N OF WORK:
Remove entire 9sq of existing roof shingles system. Install new GAF Timberline Dimensional Shingle
with new flashing, boots, jacks and pipe vents.
Install new granulated peel and stick over flat deck roof area. (1/12 pitch)
CONSTRUCTION IN;FO;RMATIO'N;:,
Additional work to enje orme under this permit— check
❑HVAC Gas Tank ❑Gas Piping
a
apply:
Shutters
❑ Windows/Doors
_I
L
_
❑Electric 0 Plumbing
❑Sprinklers
❑ Generator
Roof 3/12 Roof pitch
Total Sq. Ft of Construction:
4,125.00
Sq. Ft. of First Floor:
❑Septic
Cost of Construction: $
Utilities:
Sewer
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Richard Cernohorsky / Donna Rundell
Name: Crystal Anderson
Address:10701 South Ocean Drive, Lot #774
Company: Olneya Restoration Group, L.L.C.
City: Jensen Beach State: FL
Address: 4253 SW High Meadow Avenue
Zip Code: 34957 Fax:
City: Palm City State. FL
Phone No. 970-518-7949
Zip Code: 34990 Fax: 772-925-8417
E-Mail: dirunde1149@gmail.com
Phone No. 772-222-5019
Fill in fee simple Title Holder on next page (if different
E-Mail: Ilawrence@olneya.Com
from the Owner listed above)
State or County License: CCC1330974
If value of construction is S2500 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:
State:
Phone:
Zip: Phone.
FEE.SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: .Phone:
Zip: Phone:
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 holderto build'the subject structure
Which is in conflict with any applicable Homeowners. 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 wh(ch mayapply,
In consideration of the -granting of this requested permit, I do hereby agree that ( will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucle County Amendments.
The following building permit :applications are exemptfrom undergding.a full concurrency review: room additions,
accessory'structures, swimming pools,Jences; walls, signs, screen rooms and accessory uses to another non-residential use
.WARNING TO OWNER: Your failure to Recorda Notice -of Commencement may result in your paying1wice: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
commencinik work'or recording vour Notice of Commencement.
r as
Holder
STATE`0F P.LORIDA STATE O.FFLORIDja, e
COUNTY OF i�. ' I,fll_P.k.� COUNTY 0. C 1 h
The f rgoing.instr e t as acknowledged before 'me
this T.day of 30M 20.I_l by
(NaMLV,of
per n acknowledging.)
rv� - Ulu -
`(Signature of Notary Public- State of Florida )
Personally Known' C _ OR Produced. identification
Type of de. ratification Produ
Commission No:
Revised .07/ 1 S/201A
MEGAN IEANETTE LAWRENCE
( rgl�Public-StatoofElorido
Commlolon Y GG 047499
My Comm, Expiro Apr 24, 2021
The forgoing ins'tpwmqnt was acknowledged before me
this t day of 20 �_J_ by
(Name of erson acknowledging )
ro - J:Alomjyj
(signature(q Notary Public- State of Florida..)
Personally known X OR Produced Identification
Type of Identification Produced
missiom No.
Cor ffilolan d
REVIEWS
FRONT
COUNTER
20NING
'REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS