HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I2 `�-`� Permit Number: 1 �� 03 �-0
Building Permit Application DEC 14 2017
Planning and Development Services
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
PROPOSED IMPROVEMENT LOCATION:
Address: 15018 Aguila Ave, Fort Pierce, 34951
Legal Description:
Property Tax ID #: 130611100010000
Site Plan Name:
Project Name:
Setbacks Front Back: _
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Tear off shingle, 2/12. Install layer of polyglass Tu+. Install 5-V Sunlast Metal over
Lot No._
Block No.
CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit —check
11HVAC rl Gas Tank Gas Piping
a
apply:
Shutters
❑ Windows/Doors
_
11 Electric ❑ Plumbing
OSprinklers
Generator
❑✓— Roof 2�12 Roof pitch
Total Sq. Ft of Construction: 1500
S . Ft. of First Floor: 1500
10500
Cost of Construction: $ ,
Utilities:
Sewer
[]
Septic
Building Height:
_
OWNER/LESSEE:
CONTRACTOR:
Name John Kalita
Name: Jon ashenback
Address:15018 aguila Ave
Company: Atlantic construction and roofing
City: Fort Pierce State: _
Address: 4888 N. Kings Hwy Box #223
City: Fort Pierce State: FI
Zip Code: 34951 Fax:
Phone No. 772-595-5063
Zip Code: 34951 Fax: 772-264-0302
E-Mail:
Phone No. 772-215-3306
Fill in fee simple Title Holder on next page ( if different
` E-Mail: jashenback@gmail.com
from the Owner listed above)
State or County License: CCC-057852
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 Comme cement may result in your paying twice for
improvements to your property. A Notice of Commencement ust be recorded and posted on the jobsite
before the rst inspection. If you intend to obtain financing, c suit with lender or an attorney before
commenci work or recordini? vour Notice of Commencemen .
��N
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Signature of ner/ Lessee/Contractor as Agent for ner
Signatur Contractor/License Holder - �•
�
STATE OF FL RID
STATE OTFLORIDA g
COUNTY OF .. =
COUNTY OF a rn
The for.g�ing instr ent was acknowledged efore
The forgoing instr t was acknowledged befor
day Co 20� by
this i day of 20 by
this of
batk
oAsh t n
erson making statement .
e
rson making statement N m
Person Known OR Pdd Idtificat' ��
Produced en
Person Known OR Produced Identificati a
Type oy
on tO�
Type of I e , cation
Produced
Produced.
(Signature of Notar ublic- State of Florid'a U
(Signature of Notary blic- State of Florida )
Commission No. (Seal)
Commissi No. (Seal)
_t
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev. 8/2/17