HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: I _� Q - (0 M
WWI A EC «, VED
Building Permit Application
Planning and Development Services DEC 12 2017
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 PERNii- TI,�'1G
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial . Residentl4l �ci_ e Coin, FL
PERMIT APPLICATION FOR: Roof E
PROPOSED IMPROVEMENT LOCATION:
Address: 6101 Sunset Blvd, Fort Pierce, FL 34982
Legal Description: INDIAN RIVER ESTATES-UNIT-08- BILK 70 LOT 32 (MAP 34/11S) (OR 1048-1010)
Property Tax ID #: 3402-609-0674-000-7
Site Plan Name:
Project Name:
Setbacks Front Back:_
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Lot No.32
Block No. 70
REMOVE EXISTING SHINGLE ROOF SYSTEM AND INSTALL NEW METAL ROOF SYSTEM.
ROOF PITCH 4/12 SLOPE
CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit— check a apply:
11HVAC ID Gas Tank Gas Piping _ Shutters E]Windows/Doors
11 Electric 0 Plumbing [] Sprinklers Generator Z Roof /12 Roof pitch
Total Sq. Ft of Construction: 2000 S Ft. of First Floor:
Cost of Construction: $ 7960 UtilitiesSewer 0 Septic
Building Height: 12 FT
OWNER/LESSEE:
CONTRACTOR:
Name DEBRA FASNACHT
Name: RICARDO LARA
Address:6101 Sunset Blvd, Fort Pierce, FL 34982
Company: ELITE ROOFING SOLUTIONS, INC
City: FORT PIERCE State:FL
Zip Code: 34982 Fax:
Phone No.
E-Mail:
Address: 812 SE LINCOLN AVE
City: STUART State:FL
Zip Code: 34994 Fax:
Phone No. 772-643-7663
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: ERS.PERMITS@GMAIL.COM
State or County License: CCC1330337
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:
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 ith lender or an attorney before
commencine work or recordine vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
,Signature o ontractor/License Holder
,1
STATE OF FLORIDA
STATE OF FLO I A
COUNTY OF
COUNTYOF In
The forgoing instrument was acknowledged before me
The for ling instrument wasacknowledgedbefore me
day �!/ 20_q by
this day of 20_ by
this ofG>(ii%1 !� .
:JZe_WJ, IA"
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known _5 OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
,.kp Theresa Anne
Commission No. (Seal)
CommissiogpRYA°� NOTARY PUBLIC
(Seal)Seal
c c STATE OF FLORIDA
Comm# GG126275
b?
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
=44. U ��r l-4'v� -s rep ^-" �x Ate^`" n"xv. �,. cSgcF ' ?k°�ws d� a• yc �N / - ., - - ON LIEN LAW IRicnonnd-ricnni-.:.-.-
:�SUPPLEMENTAU�CONST'R CT�
:DESIGNER/ENGINEER Not Applicable`: 1:.
_
Address:
City: State•,
Zip: Phone
FEE'SIMPLE TITLE. HOLDER: _, Not.Applicable
Name:' .
Address:
City:
Zip: Phone:
AGE COMPANY Not Applicable =
City: —State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip:, Phone:
OWNER[CONTRACTOR AFFIDVIT: Application is'herebymadeto obtain a permit:todo the work;and installation as indicated.
I certify that no work or'installation has commenced prior to the issuance of a permit.
c*. i if in nn Verirncantatinn-fff;wic-owantirio a nerrnitwill.authoriie the,oermit holder to. build ;the subiect-structure.-.
.._ ... .. ` __
structure. Please'consuitw th your Horne 0wners'Association'an review.your ee orany'restn ions w ie may apply.
in consideration of the granting ofthis requested permlt; I do hereby agree that i Will, fn all reSpects;-perform the work
in accordance with theapproved',plans, the Florida Building Codes and:St: Lucie County"Amendments
The following°buildiing perrriitapplications:a're'ezempt?from undergoing.a full concurrency review: room additions,
accessory structures, swimming°pools,,. fences; walls, signs, screen rooms and,accessory uses to another non-residentiaLuse
WARNING'TO OWNER: Your failure to Record a Notice of`Commencernent may result In -yourpaying tyirice'for
improverrlents to your property. A Notice of Commencement must: be recorded and posted. on the jobs.Ite
before the first�ection If you intend. to obtain financing, consult. ith lender or an attorney before:
- 1.../L -..�riii.n �inl l� Al nfiin of Tnmmonrdl'n ont. / /
Si tare,of Owner/Lessee/Contractor.as Agent for•Owner
•,Signature oft. ontractor/License Holder
,J
STATE OF FLORIDA.
/�'1 -It- n
STATE OF FLOj�I�A "
COUNTY OF,tif Ff'fClh NN
COUNTY OF I
The fo goinginstr entwas acknowledged.before me
a
The forgoIng.instrument.was acknowledged before. me
day Iecy �Yi'b-�!/' 20, by
this day of 26 7P by
this an of .
Name of,person making statement
Name of person making statement
Personally Knownn_ OR:Produced Identification
Personally Known. 54 OR Produced _identification
Type of Identification
Type of Identification.
Produced
Produced
u
Si nature of'Nota Public
(g T§bA9PAfihvi3WPPo
vq
(Signature of Nota"ry Public- State of Florida' )
Y Theresa Anne.Fasano.
t NOTARY PUBLIC
Commission. N®Q OF Pl.�
t
commissio °c� NOTARY PUBLIC (Seal)
o? -
3 =C0mm#"GG126275
ESTATE OF FLORIDA
Comm# GG126275'
CAM�0 7i.19/2021.
REVIEWS'
FRONT
ZONING
SUPERVISOR'
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
:DATE
.'RECEIVED.
DATE
COMPLETED
Rev. 8/2/17