HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ''
Date: 12/18/2017 Permit Number: l 2 . 4LA".
RE NED
Building Permit Application ®EC 18 2017
Planning and Development Services
Building and Code Regulation Division PEMNIiTT!NG
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xx
PERMIT APPLICATION FOR: Roof
PROPOSED] I M PROVEMENT LOCATION:;
Address. 5717 Silver Oak Dr., Fort Pierce, Florida
Legal Description: Indian River Estates Unit 06 bIk20 lot 37 & 38
Property Tax ID #: 340260701900004
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side
DETAILED' DESCRIPTION OF WORK;
Left Side:
Lot No.
Block No.
remove existing shingle roof, renail to code, install peel-n-stick under layment, install 26 ga 5-V crimp
galvumue metal roofing system.
CONSTRUCTION INFORMATION:,
—Additional work to e nertormed under tispermit—c ec a a t appy:
1JHVAC 0 Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers FI Generator Roof 4�12 Roof pitch
Total Sq. Ft of Construction: 2100 S . Ft. of First Floor: 1700
Cost of Construction: $ 8,000.00 Utilities: 0 Sewer D Septic Building Height: 8
OWNER/LESSEE:
CONTRACTOR:
Name
Name: - 2
Address: O ✓-C
Company
��—
city: �n o State
Address:
Zip Code: Fax:
City: 2
State;Z4
Phone No.
Zip Code: Fax:
E-Mail:
Phone No.—'`y�7 3
Fill in fee simple Title Holder on next page (if different
E-Mail: i �����/� Q� �� • ! ��D%�'Z
from the Owner listed above)
State or County License: ro /y%
0
If value of construction is $2500 or more, a RECURDEo Notice or commencement is requwreo.
SlJp+pLEMENTAI CONSTRUCTION"LIEN LAW INFORMATION z
_
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address' 5717 Silver Oak Or., Fort Pierce, Florida Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone
Not Applicable
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
commencine work or recording your -Notice of Commencement. n
.---
Signature of owner/ Lessee/Contractor as Agent for Owner
Signature o Contract License Holder
STATE OF FLORIDA
STATE OF FLORI
cc�p
COUNTY OF �C:� q i P.o ,
COUNTY OF a .
The fing instr rnent was acknowledged before me
The f1o,�r oing instru ent was acknowledged before me
this day 20a_ by
thisday of 20-IL by
� of
Name of person making statement
Name of peon making statement
Personally Know OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Si nat re of Notary Public=S. te=of_Florida) .ter
4 Jt�av n�a , LASHAHNAINGRAM
(' ature of Nota Public- State f Florida)
•Rv �, LA S P 4 1NGRAM
<P j�SeHa��
Commission No. �'^a'=
Commission No. r7 :`, • 1� �: Notan(Se'al+) State of Flori„
••
Notary Public - State of Florida
•(t , •_ My Comm. Expires Dec 20.
_ My Comm. Expires Dec 20, 2018
=�� ° Commission # FF 17-
�,q, a Commission # FF 177249
%FP�F`°' a��.+� �• +-°;-
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Sonded through Na!
onal Notary Assn.
REVIEWS
R ~
ZONINVG' `_":SCJ
ERVI-
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
-REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17