HomeMy WebLinkAboutBUILDING PERMIT APPLICATION� b
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: I l V
GGANNED
® -BYRECEIVED
Buie Permi Application �A^I )RECEIVEn
Planning and Development Services Permittin
Building and Code Regulation Division St. LuUU.41,-9019
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PArmittJn9�Dii;partment
� --6re-County
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 4086 OAK HAMMOCK LN, FORT PIERCE, FL 34981
I egal Descrintinn. 29 35 40 FROM W 1/4 COR OF SEC RUN N 88 39 46 E 663.28 FT TO POB
TH S 00 3128 W 213.65 FT TO TEN MILE CREEK,TH MEANDER NWLY ON CREEK 265.95 FT
Property Tax ID #: 2429-233-0004-000-7
Site Plan Name:
Project Name:
Setbacks Front Back:_
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
REMOVE EXISTING SHINGLE ROOFING SYSTEM AND INSTALL NEW -
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(1�l?S''10'(/� 1°x i 5�'ih.P� Ylc: -P �od� cry .�i�s -f'cY �l l2e c�✓ F°L /=l i.�GUt=
Lot No.
Block No.
Additional work to be performed under tnis permit— cnecK an apply:
11HVAC Gas Tank Gas Piping _ Shutters Windows/Doors
11 Electric 0 Plumbing []Sprinklers 0 Generator Roof / Roof pitch
Total Sq. Ft of Construction: S 11840 Ft. of First Floor:
Cost of Construction: $ Utilities: _ Sewer O Septic Building Height:.��.
OWNER/LESSEE:
CONTRACTOR:
NameCAROLCARLIN
Name: RICARDOLARA
Company: ELITE ROOFING SOLUTIONS, INC
Address:4086 OAK HAMMOCK LN
City: FORT PIERCE - State:FL
Zip Code: 34981 Fax:
Phone No.772-201-5426
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Address: 812 SE LINCOLN AVE
City: STUART State:FL
Zip Code: 34994 Fax:
Phone No. 772-643-7663
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 CONST ION 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 with lender or an attorney before
commencine work or recording vour Notice of Commencement. -,--?
Si ature of Owner/ Lessee/Contractor as Agent for Owner
5 nature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
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COUNTY OF, /�%�''�'
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this_4-Zday/off 775- 9r�Y . 20C�by
this day of �,8�t/U�QY , 20�'by
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/66'1(-& 1 t*4
Name of person making statement
Name of person making statement
Y
Personally Known )a OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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Z(/✓C�i' Ica ��.
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(Signature of Notary p blic- #WAiWicl`%1ano
A
(Signature of Notary Public- State of Florida )
Theresa Anne Fasano
�tR
o.� NOTARY PUBLIC
Commission No. E OF FL�WA
W '? Comm# GG126275
,W_y_s,
s
o NOTARY PUBLIC
Commission N Seal)
F FLORIDA
Comm# GG126275
Expires 7/19/2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
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MANGROVE
COUNTER
REVIEW
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REVI
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
tev. 8/2/17