HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3__% Permit Number:
BAQ ,"NNE®
�me' Permit Aoolication
Planning and Development Services St Ludo 0OU01 wu-ul a wOU
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxxxxxxx
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:,
na 1 1-1 ^A-
Aaaress: * w0 CI IV v1, ry�J . U%'IV, I I- %J_r17.rr_
Legal Description. La Buona Vita Cooperative Unit/Lot 4 (OR 1857-2537)
Property Tax ID #: 3426-664-0004-000-5
Site Plan Name:
Project Name:
Setbacks Front Back:
J D:ETAILED DESCRIPTION OF WORK;
Right Side:
REMOVE EXISTING ROOF & REPLACE ANY ROT
INSTALL ASTM-226 30# UNDERLAYMENT
INSTALL 26 GA METAL ROOF SYSTEM
Left Side:
/V\ OB I L6
/Cp�'
Lot No. 4
Block No.
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit— check all that apply-:--
11HVAC Gas Tank ❑Gas Piping _Shutters ❑ Windows/Doors
11 Electric 0 Plumbing Sprinklers F]Generator W Roof
Total Sq. Ft of Construction:0
Cost of Construction: $__LL, d,0 6
S Ft. of First Floor: _
Utilities:Sewer Septic
Building Height:
.'OWNER/LESSEE:
CONTRACTOR:
Name William E. Joycelyn & Helen L. Quick
Name: JOE BAKER
Company: BIG LAKE ROOFING & REPAIRS
Address: 411 Natalie Dr. Lot #4
Address: 2699 NW 16TH BLVD.
City: Port St. Lucie State: FL
Zip Code: 34952 Fax:
City: OKEECHOBEE State: FL
Phone No. 772-343-9576
Zip Code: 34972 Fax: 863-763-7662
E-Mail:
Phone No. 863-763-7663
Fill in fee simple Title Holder on next page ( if different
E-Mail: BIGLAKEROOFING@YAHOO.COM
from the owner listed above)
State or County License: CCC046939
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. II
CONTPArTnD rvr,nxr
I
;SUPPLEMENTAL CONSTRUCTION LIEN LAW ;INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: 14Not 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:
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 duo hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building lCodes 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 regording your Notice of Commencement.
Signature of Owner/ Agent/ Lessee Signature of Contractor/License Holder
STATE OF FLORI STATE OF FLORIDA
COUNTY OFCOUNTY OF Q K&"� �
I
The forg9ing instr ment was ac nowledgggk0efore me I The or inay
instrument was a knowiedg _ efore me
this I iMay of 208—by this ay of 20;� by
(Name of person acknowledging) (Name of person acknowle ging )
ature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Personally Known 9",-, OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
TO*
EXPIRES: May 21, 2018
www.AARONNOTARY.COM
Personally Known — OR Produced Identification
Type of Identificatio Produced
Commission No. `\\,4,,, JSealNe ther
EXPIRES: May 21,
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