HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONME.
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I Permit Number: I�
SCANNOD
®^ I Y RECEIVED
IMIM lye'*Mit Application
FEB 2,2 2010
Planning and Development Services
epartment
Building and Code Regulation Division permitting Luc County
2300 Virginia Avenue, Fort Pierce FL 34982 I St. Lucie County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof I j-
PROPOSED IMPROVEMENT LOCATION:
Address: 5009 LACE AVE, FORT PIERCE, FL 34982
Legal Description. CENTRAL WHITE CITY S/D BILK 3 LOTS 9, 10 AND 11
Property Tax ID #: 3403-804-0037-000-2
Site Plan Name:
Project Name:
Setbacks Front Back:_
Right Side: Left Side:
Lot No. 9,10,11
Block No. 3
DETAILED DESCRIPTION OF WORK: I
REMOVE EXISTING SHINGLE ROOFI
SYSTEM.
3/12 SLOPE
SYSTEM AND INSTALL NEW METAL ROOFING
CONSTRUCTION INFORMATION:
Add itiona I work to be nertormed under this permit —check
�HVAC Gas Tank ❑Gas Piping
all
apply:
Shutters
0 Windows/Doors
_In
Electric 0 Plumbing
Sprinklers
E Generator
9 Roof /12 Roof pitch
Total Sq. Ft of Construction: 2000
I
S . Ft. of First Floor:
Cost of Construction: $ 9600
I Utilities:
i
Sewer
Septic
Building Height: 12'
OWNER/LESSEE:
CONTRACTOR:
Name DEBRA FASNACHT I
Name: RICARDO LARA
Address: 5511 SUNSET BLVD
City: FT PIERCE State: FL
Zip Code: 34982 Fax:
Phone No. 772-489-3771
E-Mail:
Company: ELITE ROOFING SOLUTIONS,INC
Address: 812 SE LINCOLN AVE
City: STUART State: FL
Zip Code: 34994 Fax:
Phone No. 772-643-7663
Fill in fee simple Title Holder on next page (if different
from the Owner listed above) I
E-Mail: ERS.PERM ITS@GMAIL.COM
State or County License: CCC1330337
If value of construction is $2500 or more, a RECORDED, Notice of Commencement is required.
SUPPLEMENTAL CONSTRU .N LIEN LAW INFORMATION: u
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: Stater_ City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: I 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 Assocjation 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 f Iom 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
rnmmnn rind %e[nrL, nr rornrrlinQ \/nl Ir nint'irP of 1(-nmmPnrPmPn1'
i ature o Owner/ Lessee/Contractor as Agent for Obuner
S
Sign u400ntractorILLicense Holder
STATE OCOUNTY
STATE f f,PJ
OFORIDA
�l�
COUNTOY OFORID/_)
The forgoing instr e t was acknowledge before me
this A%ay of 2,tZL� 20 by
The forgoing ins"m nt was acknowledged before me
this _Li( day of V-Mlta A� 20L by
4e�
�!
Name of person making statement
Name of person making statement
Personally Known �_ OR Produced Identificatior
Personally Known _ e OR Produced Identification
Type of Identification
Type of Identification
Produced -
Produced
A
KYbfi6eft84 A6f`4FII5@W9
(Signature of N$Q*C8S11b
(Signature of Notary Public- State of Florida )
NOTARY PUBLIC
Commission -STATE OF FLOR(496a1)
A� Theresa Anne Fas�p
Commission No:.; : ass 6TAf�Y PUBLIC 1'�al)
Comm# GG126275
Expires 7/18/2021
'
it ESTATE OF FLORIDA
= Comm# GG126275
'vCE i9� Ex
ires 7/19/2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLAN
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
RE
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
�I I
COMPLETED
Rev. 8/2/17