HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MU5T BE COMPLETED FOR APPLICATION TO BE ACCEPTED
--` s
Date: S. (OA�qF�JPermit Numb:
BY
St Lucie Count,
Building''. Permit Application
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
RECEIVED
JAN 2 3 2018
5T, Lucie County, Petrmltting
Residential X
PERMIT APPLICATION FOR: Roof El I
PROPOSED IMPROVEMENT LOCATION:
Address: 10725 S OCEAN DR LOT 407 JENSEN BEACH FL. 34957
Legal Description: HOLIDAY OUT AT ST LUCIE - SEC B BLK Q LOT 5 AND EQUAL PRO-RATA INTEREST IN
COMMON ELEMENTS (OR 1410-758; 1620-1929; 2121-1626; 2728-1244; 3996-536; 4000-598)
Property Tax ID #: 4511-502-0122-000-3 Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: VpZ)', \,P
Block No.
TEAR OFF EXISTING SHINGLE ROOF AND INSTALL NEW 5-- V. Ai 9'CL—F441SN PY1EW41_ ROOF
312- �; ; emu.
CONSTRUCTION INFORMATION:
Additional work to be nerformed under
E1HVAC Gas Tank
this permit— check
®Gas Piping
all apply:
_ Shutters
E] Windows/Doors
FlElectric Plumbing
Sprinklers
F]Generator
R1 Roof
Total Sq. Ft of Construction: 790
S�Ftj of First Floor:
®
Cost of Construction: $ 6,450.00
Utilities:
LJ Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Peggy Guimond or Carol Brennan
Name: Ronald Latta
Address: 23 Hoover Rd
Company: Treasure Coast Concepts Inc.
City: Northborough State: MA
Address: 3458 SW Pluto St
Zip Code: 01532 Fax:
City: Port Saint Lucie State: FL
Phone No. 617-347-5188
Zip Code: 34953 Fax: 772-905-4910
Phone No. 772-777-8130
E-Mail: jQ 1--M
Fill in fee simple dIe Holder on n page ( if different
E-Mail: tcconcepts@aol.com
from the Owner listed above)
State or County License: CCC1330362
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL• CONSTRUCTO T _'JEN. LAW INFORMATION:.. -
DESIGNER/ENGINEER: x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone i
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x 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
cnmmonrinv wnrk nr rer_ordinu vour Notice of Commencement. 17 -.r
--------------- -- - - -- - - - - - - - -- -
Fit —nature of Owner/ Lessee/Contractor as Agent for Owner
Si "' ure Contract c nse Hol er"
STATE OF FLORIDA ,,
ATE OF FLO DA
COUNTY OF 31�
COUNTY OF
The forrg$oing instrument was acknowledged before me Y
The forgping inst ent was acknowledgebefore me
this � 20 by
this Z`1 day of �4a.. > , 2dU3— by
ay of
Name of person making statement
Name of person making statement ✓
Personally Known OR Produced Identification �'�
Personally Known OR Produced Identification
Type of Identification
Produced
Type of Identification ry�
Produced
(Signature of Notary Public- State of Florida
Signature of Notary Public- State of Florida )
......e "''•
Commission No. 11. ". ." `� ; (�e�A A GALVIN
�."� KA R E N S ,*L S E N�
mmission No. .';•a' °°B''-, 'k`F>•' 115637
MY COMMISSION #FF0913
` 9 'Q EXPIRES February 10, 201
5
;, mmissio
iv '= My Commission Expires Ii
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••••
June 12, 2018
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Rev. 8/2/17