HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: OC
SCANNED RECEIVED
• �4 Lucile �DUit�v FEB 121018
.. ,,,..,...._......_...'.. __,...........I' I'll ....: Permitting
DepartmentBuildin Permit Application St. Lucie County
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 Residential x
PERMIT APPLICATION FOR: Roof i=
i
PROPOSED IMPROVEMENT LOCATION:
Address: 9628 ENCLAVE CIRCLE, PORT ST LUCIE, FL 34952
Legal Description: ENCLAVE AT THE RESERVE LOT 8
Property Tax ID #: 3322-800-0011-000-4
Site Plan Name:
Project Name: 9628 ENCLAVE CIRCLE
Setbacks Front Back: _
DETAILED DESCRIPTION OF WORK:
Right
Left Side:
Lot No. 8
Block No.
IREMOVE EXISTING ILE ROOFING SYSTEM AND ADHERING NG UNDERLAYMENTSTALL NEW METAL ROOF WITH 2 LAYERS
OF POLYGLASS SELFI
8/12 SLOPE
"I,
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit _ c ec
�HVAC Gas Tank Gas Piping
all
apply:
Shutters
❑ Windows/Doors
Electric 0 Plumbing
I
Sprinklers
ElGenerator
Roof 8/12 Roof pitch
Total Sq. Ft of Construction: 17900
S Ft. of First Floor:
Cost of Construction: $ 234850
Utilities.
Sewer
El
Septic
Building Height: 12'
OWNERAESSEE:
CONTRACTOR:
Name DOUG GOSCHKE
Name: RICARDO LARA
Address: 9628 ENCLAVE CIR
Company: ELITE ROOFING SOLUTIONS, INC
Address: 812 SE LINCOLN AVE
City: PORT ST LUCIE State: FIL
Zip Code: 34986 Fax:
City: STUART State: FL
Phone No.772-201-7363
Zip Code: 34994 Fax:
E-Mail:
Phone No. 772-643-7663
Fill in fee simple Title Holder on next page (if different
E-Mail: ERS.PERMITS@GMAIL.COM
from the Owner listed above)
State or County License: CCC1330337
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
7
I I
SUPPLEMENTAL CONSTR ION LIEN LAW
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.
I
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
commencingw rk or recordingour Notice of Commencement.
Rev. 8/2/17
INFORMATION:
DESIGNER/ENGINEER:
_ Not Applicablei
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
Address:
�
Address:
City:
State:
City:
State:
Zip: Phone
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable'
BONDING COMPANY:
Not Applicable
Name:
�
Name:
Address:
Address:
City:
City:
�
Zip: Phone:
Zip: Phone:
Sign ure of Owner/ Lessee/Contractor as Agent for Owner
Sig ture of Contractor/License Holder
S ATE OF FLORID"A-
TATE OF FLORIDA /
COUNTY OF JYJl9t�i�
�
COUNTY OF J�i��l=�✓�
i
The forgoing instrument was acknowledged before me I
The forgoing instryq�e�t was acknowledged before me
this � day of 20� by
this � day of 20 /f' by
Name of perso making statement
Name of person making statement
Personally Known � OR Produced Identification
Personally Known �_ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida )
(Signature of Notary Public- State of Florida)
Theresa
D�pRY Anne Fasano
�
� NOTARY PUB dal)
Commission No.a
Theresa Anne Fasano
Commiss'� .'�s' 6TARa
_