HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 'off' ) SCANNED Permit Number: I D 07 j
St Lucie Ca u*
Building Permit Application
Planning and Development Services 2010v Building and Code Regulation Division MAR
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553' Fax: (772) 462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address`, VVW� I p( -%I rllQA / n --kit 1
Legal Description::�400�77
WINDMILL VILLAGE BY THE SEA-UNITTWO- BLK A E 36.72 FT OF LOT 15 (OR 3094-121
Property Tax ID #: 4511-811-0016-000-6
Site Plan Name:
Project Name:
Setbacks Front Back: _
Right Side: Left Side:
Lot No.IC6
Block No.
IINSTALL A NEW 5V METAL ROOF SYSTEM AND REPLACE EXISTING (2) SKYLIGHTS. PITCH
4/12
Additional work to be ertormed under this' permit —check all apply:
DHVAC E] Gas Tank DGas Piping Shutters Windows/Doors
0 Electric 0 Plumbing Sprinklers 0 Generator Roof 4/12 Roof pitch
Total Sq. Ft of Construction: 1800 S Ft. of First Floor:
Cost of Construction: $ 10,000 Utilities:Sewer E Septic Building Height: 15
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OWNERJLESS�E fi , , , '
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CONTRA OR `�
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Name
Name:
Name:
Address:
Company*, ONSHOR ROO G SPECIALISTS, INC
City:
State:FIL
Addres
Zip Code• Fax:
City: State: FL
Phone No. 772-342-1148
Zip Code: 34996 Fax: 772-283-1557
E-Mail:
Phone No.. 772-283-1505
Fill in fee simple Title Holder on next
page (if different
E-Mail: INFO@ONSHOREROOFING.00M
from the Owner listed above)
State or County License: CCC1328994
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
r � r
R
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:_
Address:
City:
Zip:
one:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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, si as, —screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure tgg.RR cord a Notice of Commencement may result in your paying twice for
improvements to your propert��lotice of Commencement must be recorded and posted on the jobsite
before the first inspection. If,�yy u intend to obtain financing, consult with lender or an attorney before
commencine workDr:tecsfdinta vour Notice of Commencement.
Signatur of r see/Contractor as Agent for Owner
' nat a ontractor/License
Holder
c
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF i
The for oing instrurn t was ack wledged^fore me
this � of / by ,
The for oing instrument was act owledged fore me
this : day of y
ay
ego (`
Name of person ma ' g statement
Name of p rson aki g statement
Personally Known OR Produced Identification
Personally KnownOR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
%
(Signature of to Public- St t I r'
(Signature of Nota P blic- State o lorlda )
Comm! io Notary P state sn Florseal)
Hirtchinso
Commission No d No tic Statj�gl�b 'sin
�v My Commission GG 146949
'ry Expires 10/01/2021
rss a Neal Hutchinson
,s• MY Commission GG 146949
Expires
10/01/2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VVEGETATION
SEA TURTLE
M ROVE
COUNTER
REVIEW
REVIEW
REVIE
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
I
Rev. 8/2/17