HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONF
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED .
Date: `• �� • �� I Permit Number: O �Q
SCANNED
=� BY RECEIVED
• �t iude County i
Buil ing Permit,'Application I JAN 2 9 2018
Planning and Development Services SfiLucie County, i Permitting
Building and Code Regulation Division :
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
I
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED= IMPROVEMENT -LOCATION ¢
Address: 128 N. Las Olas Dr. Jensen Beach 34958 I
Legal Description: Bay Colony Section 1 Lot 12
Property Tax ID #: 4511 500 0024 000 0
Site Plan Name: Bay Colony
Project Name: New Metal Roof
Setbacks Front Back:
Right Side., Left Side:
DETAILED DESCRIPTION OF WORK
Remove Asphalt shingles and install 'new 5V Crimp Metal Roof
Lot No.12
Block No.
CONSTRUCTION INFORMATION
Additional work to a e orme under this permit — c ec
11HVAC 13 Gas Piping
a
apply:
Shutters
Windows/Doors
Gas Tank
_
Electric 0 Plumbing
Sprinklers
Generator
Roof 2 Roof pitch
Total Sq. Ft of Construction: 2000
I
1S�Ftj
of First Floor:
Cost of Construction: $ 4,800
Utilities:
USewer
Septic
Building Height: 151ft
;OWNER/LESSEE . ;. :: " .a,
CONTRACTOR:',
Name Lawrence Doye
Address:128 N. Las Olas'
Name: Harry A. Hery
Company: Pinnacle Roofing Sery
City: Jensen Beach State:FL
Zip Code: Fax:-
Phone No.
Address: 5905 SW Markel St
City: Palm City State: FL
Zip Code: 34990 Fax:
Phone No. 772-349-2735
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: SUMMACOR@GMAIL.COM
State or County License: CCC 1326 185
If value of construction is $2500 or more, a RECORDED Notice or Commencement is requirea.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: I _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
N a m e: Lawrerice Doye N a rh e: Hairy A. Hery
Add ress: 128 N. Las Dim Dr. Jensen BeacO4958 Address: 128 N. Las Olas
City: Jensen Beach I State: City: Palm City State:
Zip: Phone I Zip: Phone:
I
FEE SIMPLE TITLE HOLDER: I _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:5905 SW Markel St I Address:
City: City:
Zip: Phone: I Zip: Phone:
I
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 applicablelHome 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 thislrequested 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
kl—+ire .,f ('•nmmonromant
commencing wuiK Ui it.LUI U11 ig YUU1 IMWLI .c
I
�
Signature of Owner essee/ ntractor a Agent for Owner
Signature o ntractor icense Ho er
STATE OF FLORIDA I
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The fo oing instr ment was acknowled le efore me
20by
The fo oing instru ent was acknowledged_before me
thins day of 20by
this day of
�A
9
Name f person making statement /
Personally Known OR Produced Identification !�
—�Aeyrt -
Name f person making tatemerit
✓
Personally Known . OR Produced Identification _
Type of Identification
Type of Identifica ,—
Produced
Produced
(Signature of Notary Public- State of Floridal)
(Signature of Notary Public- State of Florida )
e
Commission No. ,iiri,i KARE 3. NIELSEN
Commission No. : "'a:ia"�,
AREN
-'� NIELSEN
Commission # FF 115637
=• •= Expii es
__* Commission # FF 1 7
<� My com 5637
My Commission
missi
une 12,
018
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DATE
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COMPLETED
Rev. 8/2/17