HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE NFO M ST BE COMPLETED FOR Ifc�►�!2VIfO BE ACCEPTED /
Date: �� �� Permit Number: / 1
Permitting Dept. St. Lucie County, FL -W 'tilunoD april •;S •4daa 6ul:glwjgd
Building Permit Application LIOZ 99 1j0
Planning and Development Services a3A3103a
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof
Address: 5203 S. Indian River Drive, Fort Pierce, FL 34982
Legal Description: J O FRIES S/D 79.16 FT OF LOT 3
Property Tax ID #: 3401-600-0004-000-0 Lot No. 3
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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11 Electric 0 Plumbing []Sprinklers 1:1 Generator W Roof 1/12
Total Sq. Ft of Construction: 618 S . Ft. of First Floor: 2,068
Cost of Construction: $ 7,500 Utilities: Sewer Septic Building Height: 1
ing Ll Shutters Q Windows/Doors
Roof pitch
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Name Gary Sparks 2S
Name: Richard V. Colletti
Address: 5203 S. Indian River Drive
Company: Leak Busters Roof Repairs, LLC
Address: 6101 Buchanan Drive
City. Fort Pierce State: FL
City: Fort Pierce State. FL
Zip Code: 34982 Fax:
Phone No. 561-714-2391
Zip Code: 34982 Fax: 772-264-0378
E-Mail: pbcsparks@gmail.com
Phone No. 772-332-8450
Fill in fee simple Title Holder on next page ( if different
E-Mail: richiecollefti@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.
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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:
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 vour Notice of Commencement.
Sign
STATE OF FLORIDA
COUNTY OF 5- . %,_�Ca 4.
as Agent for Owner
The forgoing instrument was acknowledged before me
this i7 day of Oc-Vpb 1r , 20 11—by
46'. 4 - ( re-"arw� s
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF n� . LucSe—
The forgoing instrument was acknowledged before me
this 3,D day of C)C_ 20 _a_ by
(Name of person acknowledging) (Name of person acknowledging)
rPbJ �e� '_?W�
(Signature otary Pu lic- State of Florida) (Signatur f Notary ublic- State of Florida )
Personally Known �— OR Produced Identification Personally Known Y OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. ion No.. ,,`,9R.ALLY PORTES
S
SALLY PORT ;moo •,.
Sion N GG 47625 _* *L Commission GG 4762E
°* * My Commission Expitesec
Revised 07/15/2014 �yn''�o.n�� November 15, 2020 November 15, 2020
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