HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Permit Number: �� o�i. • V�
Date:
R E C ism V E D
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Building Permit Application DEC 2017
Planning and Development Services
PERMITTING
Building and Code Regulation Division
St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 1 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Roof
El
PROPOSED IMPROVEMENT LOCATION:
Address: 902 JACKSON WAY, FORT PIERCE, FL 34949
Legal Description: COASTAL COVE UNIT 1 LOT 15
Property Tax ID #: 1423-802-0017-000-6
Lot No.15
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back: Right Side:
Left Side:
DETAILED DESCRIPTION Of WORK:
REMOVE EXISTING SHINGLE ROOF SYSTEM AND INSTALL NEW METAL ROOF SYSTEM.
ROOF PITCH 5/12 SLOPE
CONSTRUCTION INFORMATION:
AaClitional work to be performed under this permit- checlall apply.
LIHVAC ❑Gas Shutters Windows/Doors
Gas Tank Piping
_ I]
0- Electric 0 Plumbing Sprinklers
0 Generator Roof /12 Roof pitch
Total Sq. Ft of Construction: 2700
S . Ft. of First Floor:
Cost of Construction: $ 13850 Utilities: Sewer Septic Building Height; 12FT
OWNERAESSEE:
CONTRACTOR:
Name DEBRA FASNACHT
Name: RICARDO LARA
Address: 902 JACKSON WAY
Company: ELITE ROOFING SOLUTIONS, INC
Address: 812 SE LINCOLN AVE
City: FORT PIERCE State:FL
Zip Code: 34949 Fax:
City: STUART FL
State:
Phone No.
-Zip Code: 34994 Fax:
E-Mail:
Phone No. 772-643-7663
E-Mail: ERS.PERMITS@GMAIL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: CCC1330337
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
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
rnmmanrina wnrle nr rarnrrlina vnur Nntire of Cnmmencement_ i7
Signature of Owner/ Lessee/Contractor as Agent for Owner
t r ae of Contractor/License Holder
Z
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF 19� n
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 20_ by
this day of o&e4Yi1-,w , 20 (7 by
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known -)6 OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary PubMAgfkiAAo
NOTARY PUBLIC
Commission No. (Seal)
Commission °_ F FLOROAal)
Y Comm# GG126275
i �b 2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
SUPPLEMENTAL CONSTRUCTCON LIEN LAW INFORMATION
F � "_� � l
F
"DESIGNER%ENGINEER: _;Not=Appljeable
°:�- --
-MORTGAGE COMPANY
--_Not Applieableiu-
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:
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 conffllict with any. applicable Home Owners Association rules, bylaws or and covenants that,may restrict or prohibit such
structure. Please consult with'yourHome 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 Itspects, 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 ins ection. If you intend to obtain financing; consult ith lender or an attorney before
commencin r r recordingour Notice of'Commencement.
Rev. 8/2/.17
qh
'1L, dlf,� .
4112 4C
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40
g
Sig - re of Own r/ Lessee/Contractor as Agent for Owner
,,S gnature o ontractor/License Holder
STATE OF FLORIDA
STATE OF FLOjtI�"A
COUNTY OF /I'�;`i'��N
COUNTY OF=,M
'The forgoing inst en, t was acknowledged before me
The for,going'instrumentwas acknowledged before,me,
this day �CG3'h iZ-� 20� by
this �d day of 20� by
� of ,
tCA�dO tAlfA
Name of person making statement
Name. of person making