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Date: - c�-I • .2 10 `1- I Permit Number: I LJ
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Building Permit Application AUG 2 1 2017
Planning and Development Services PERfriIT 1I'.G
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 3006 N. 25th Street, Fort Pierce, FL 34982
Legal Description: SAN LUCIE PLAZA S/D-UNIT ONE - BLK 45 LOTS 23 AND 24 AND S 17.6 FT OF LOT 25
Property Tax ID #: 1428-702-0921-000-4 Lot No. 23,24
Site Plan Name: Block No. 45
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
120�IC' acti+�j 5h�ncjle Ur r�4 lUd �{ wcxxl ; nc cear� . Q e-nG,;
P,,L'wd c�tc � Av code. =nsia(l n-cw l slicks, 6005cncckS, and �las%►�ncJ:=r,s�c�Il T►'i-[bull}
SIr ! -1-U Unc�erki�mer�k FL1(r0gT-Q.y — '�'r,�y}G�l r,ec,� 5U t)+60k1 ryv_c,A Crimp
5 4em • 11�:Lxq(A S .a -2,:L- .
CONSTRUCTION INFORMATION:
Additional work to be nertorme under tispermit-check all apply:
E1HVAC Gas Tank Gas Piping _ Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator W1 Roof Roof pitch
Total Sq. Ft of Construction: 1,276 Sq.
of First Floor: 1,276
Cost of Construction: $ 9,550 Utilities: L_ISewer Septic Building Height: 1
OWNER/LESSEE:
CONTRACTOR:
Name Keith Pickering
Name: Richard V. Colletti
Address: 3209 S. Lakeview Cir, Apt. 8101
Company: Leak Busters Roof Repairs, LLC
City: Fort Pierce State: FL
Address: 6101 Buchanan Drive
Zip Code: 34949 Fax:
City: Fort Pierce State: FL
Phone No. 772-971-6237
Zip Code: 34982 Fax: 772-264-0378
E-Mail: kcplegal@hotmail.com
Phone No. 772-332-8450
Fill in fee simple Title Holder on next page (if different
E-Mail: richiecolletti@gmail.com
from the Owner listed above)
State or County License: CCC1330976
If value of construction is $2500 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:
City:
Address:
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 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.
as Agent for Owner
er
STATE OF FLORIDA 1COUINTYOF
STATE OF FLORIDA
COUNTYOF �Ajn2� L?ca� SQ.nit Lie a
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 2L day of N a 20 Eby this _2L day of Ruau4 20 1-1_ by
q,) C, a--f 8 \I . Col\2 2,1 e na CCA \11 - CK-Apa-W
(Name of person acknowledging) (Name of person acknowledging)
161 1 2.0-1&0 J,2 JP " ,
(Sigdature of Ootary Public- State of Florida) (Sigrdture of N tary Public- State of Florida )
Personally Known )( OR Produced Identification
Type of Identification Produced
Commission No.
SALLY PORTES
d�'Ay My Commission Expires
Revised 07/15/201411
";���•`° November 15, 2020
Personally Known )—OR Produced Identification
Type of Identification Produced -
mission No. S (Seal
SALLY PORTES
GG 5
1 .E My Commission Expires
"%'-4,November 15, 2020
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