HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: V z? Permit Number:
BY RECEIVED
• S$ Lucie County
Building Permit Application , JAN 222018
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 5004 La Salle Street, Port St Lucie, FL:34951
Legal Description: Lakewood Park Unit 12-A BLK 174 Lot 2 (map 13/13N) (Or 3438-1478)
Property Tax ID #: 1301-615-0139-000-8 ! Lot No. 2
Site Plan Name: Dera Agostino Block No. 174
Project Name: 5V Metal Reroof
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
5V Metal Reroof 26 sq; 4:12 pitch; plywood decking; HT 15 FT
CONSTRUCTION INFORMATION:
Additional work to e nertormed under this permit— check a apply:
0HVAC0 Gas Tank ❑Gas Piping In Shutters Q Windows/Doors
_
11 Electric 0 Plumbing Sprinklers E Generator W] Roof
Total Sq. Ft of Construction: S�Ftj of First Floor:
,/20
Cost of Construction: $ X' GU Utilities: L_ISewer 0Septic Building Height: 15 FT
OWNERAESSEE:
CONTRACTOR:
Name Debra Agostino
Name: Dominick Agostino
Address:1951 SW Hickock Terrace
Company: RoofPro
City: Port St Lucie State: FL
Address: 6555 Garden Road #18
Zip Code: 34953 Fax:
City: Riviera Beach State: FL
Phone No.
Zip Code: 33404 Fax: 561-370-6812
E-Mail:
Phone No. 561-249-0247
Fill in fee simple Title Holder on next page ( if different
E-Mail: RoofPro411@gmail.com
from the Owner listed above)
State or County License: CCC1330094
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:
1 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
commencing work or recording your Notice of Commencement.
Signature of Owner/
STATE OF FLORIDA pod
��COUNTY OF I
The forfoin instr ment was acknowle ed before me
this' 4 day of 20!%S,4 by
11 aJ 11
(Name of erson acknowledging
_'? J"\,
(Signature of No Pu c- a e of Florida )
ersonally Kno OR Produced Identification
ype o enti cation Produced
Commission N
KIMBERLEY RENEE WARNER
In # GG 024573
Revised 07/1_U 1 ` ug 25, 2020
Signature of Contracto kense lder
STATE OF FLORIDACOUNTYOF
The f r ing instru ent was acknowledged before me
this day of iQ 20 by
Ab
(Name o person acknowledging) "
,
(Signat re of Notaryublic- State of Florida )
ersonall fr OR Produced Identification
Type of Identification Produced
Commission No. eal)
KIMBERLE KENNEE WARNER
Y
= z • A, ,, rantary Public - State of Florida
My Comm. Expires Aug 25, 2020
REVIEWS
RVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
1FYIEKIMI
EM E WA
NEik IEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
Co
mission # GG 024
73COMPLETE
%r
Aug 9c
INITIALS
Il%