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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETEu rOR APPLICATION TO BE ACCEPTED ` Date: u�p Permit Number: I L4 _ NOV 0 6 2017 Building Permit Application PERMITTING Planning and Development Services St. Lucie County, FL Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential '\ Address: Legal Description: Property Tax ID #: o'��,�=�CZ� f' I `- ' Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: Mechanical _ Gas Tank _ Gas Piping .1 Electri' Plumbing _ Sprinklers Total Sq,+t of Construction: 0 5 - Cost of Construction: $ Q, r Utiliti( :1 ,f titters Gb erator Sq. Ft. of First Floor: s: Sewer Septic Windows/Doors Roof -Pitch Building Height: OWNER/!E�SSEE: C®NTRACiOR: Name' A C& 44WAO Name: Co}mpanty=' pin Address:. City: ' © State: FL Address: 11Q U Infi R City: Statd. Zip Code: q Fax: Phone No. 7,, _L( , Zip Code: WLI Fax: E-Mail: �" Phone No A Fill in fee simple Title Holder on next page ( if different E-Mail 1 , State or County License ii caJY1 9 from the Owner listed above) it If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. i SUPPLEMENTAL CC; STR,UCTION LIEN LAW NFORMAT!©.N: DESIGNER/ENGINEER: _ Not Applicable I MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: /1 City: ° I State: City: State: Zip: Phone I I Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: A_ Address: 4 I Address: City: City: Zip: Phone: Zip: Phone: I I 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 ti improvements to your property. A N before the first inspection. If you int( commencing worker recordinP,your Record a Notice of Commencement may result in your paying twice for tice of Commencement must be recorded and posted on the jobsite id to obtain financing, coI suit with ender or an attorney before Jotice of Commencemenf'. y i Signature er Le ee/Contractor as A' ent for O+ /ner Sig a tor/License er — STATE OF FLORID o % GI� � STATE F FLORID kuC%COUNTY OF Old /-cI COUNTY OF ,t� The forming instrume t was acknowledge before me s thiday of Il pvn 20 by The for instrum nt was acknowledge efore me this day of Ne"f e.VYi �'20nby r- 000i +y N°> A 5 wv J - � . � (Name of per acknowledging) � (Name o erson acknowledging) foc I n o Q y z O (Si ature of Notary Public- State of Florida) xo• u ory - m (Sign a of Nota Public- State of Florida) m 3 x 3 •� 3 o OR Produced Ide ifii,a$ion Kno OR Produced Identi 0• 3. JaDi� Type of Identification ! o c m —' .i Type of Identi ication w ProducedProduced ;A m O'Oo Commission No.' L �II'dJ_ (Sea ' Commission No. 0 (Sea CD N w 5 r • a i • REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW RiEVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED I DATE COMPLETED I ev. i i JOSEPH E. SMITH, FILE # 4378711 CLERK OF' °iE CIRCUIT COURT - SAINT LU' 'I COUNTY OR BOOK 4�:,;3 PAGE 1569, Recorded 12/0`6j12017 03:07:28 PM NOTICE OF COMMENCEMENT i a Permit No. Property Tax ID No. 2405-601-0117-000-7 �F State of Florida, County of St. Lucie M U- y Q W The Undersigned hereby gives notice that improvement will be made to certain real property, and in accordance ? U Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. Jz Legal Description of property and address if available SUNLAND GARDENS BLK 6 LOTS 16 AND 17, 3602 AvZ-8 ? U �General ju tQOwnerllessee description of improvements Remove and replace pitched roof with Architectural shingles and torch applied Dena Matthews p z Address 3602 Avenue R, Fort Pierce, FL 34947 Luz ..s _y m Interest in property: Owner y�- 0 p Fee Simple Title holder (if other than owner) NIA Address Contractor Andros Roofing'Construction LLC Phone # 772-4754915 Address 2706 Atlantic Ave. Fort Pierce FI, 34947 Fax # Surety NIA Phone # Address Fax # Amount of Bond Lender NIA Phone # Address Fax # Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13 (a) 7., Florida Statues: Name NIA Phone # Address Fax # In addition to himself, owner designates of Phone # to receive a copy of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes. Expiration date of notice of commencement is one year from the date of recording unless a different date is specified. WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF TH6 NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CH.713.13, F.S., AND CAN 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 INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFO COMM[NCING WORK OR RECORDING YOUR NOTICE OF COMMENCMENT. I . Owner/Lessee, or Owner's of Lessee's A1Woorked OIIIcer/Director/Partner/Managert Signature Signatory's Thle/Olnee State of Florida, County oft i Q. � jr Acknowledged before me this , day of .20�, by /� 14,q s personally loco n t or who has produced �,� J� `yJ P� S �I>�p- as identlficatron. a ure of tary Type or Print Name of Notary �_ ��� 5 3 e"A) Janett Mika- Stateof Title: Note Public Commission Number NotarymissionXG051FI�A1�Commiselon*GOb/ti3! Expires 11/3W2020 Public Works Department Code Compliance Division 2300 Virginia Avenue Fort Pierce, FL 34982 772-462-2172 Fax:772-462-6443 INSPECTION AFFIDAVIT Re: Permit # `1 »" 15 1 I, n t" licensed as a(nC"" /Engineer/Architect (Please prid name & circle license type) *FS468 Building Inspector *General, Building, Residential or Roofing Contractor or any individual certified under 468 F.S. to make such an inspection. On or about I did personally inspect the roof deck nailing and/or (Date} (circle those that apply) secondary water barrier work at:. (Job site address) Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.) Signature and S 1 License # STATE OF FL'R J�A COUNTY OF - LudI e— Sworgt' andrbscri ed befor me this P— day of Dtg(1.2i�'l,� 20IJ by LJ � �a Who s persouaLy known to me or who has produced as identification. Notary Public, State of Signature of Notary:_ Commission Number: En 09/17/09 JbhOtt Miles R S �IiWrV#61io=vtateotFlorida � __ r�o7iirtli's�Tan�t;G�'1833 � 'ESCpirbs �'1'lBaIZOZD