HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 I $�6�� Permit Numb
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division,)
2300 Virginia Avenue, Fort Pierce FL 34982
RECEIVED
MAR 2 0 2018
ST. Lucie County,
Phone: (772) 462-1553 Fax: (772,) 462-1578 Commercial Residential
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PERMIT APPLICATION FOR Roof ���� W��,ln Ig ,•�
PROPOSED IMPROVEMENT LOCATION:
Address: 5409 BUCHNAN DRIVE,
Legal Description: INDIAN RIVER
Property Tax ID #: 3402-602-0197I-000-
Site Plan Name: f
Project Name: WILLIS RES
Setbacks Front (Back:
PIERCE, FL 34982
TES -UNIT 1 -BLK 6.-LOTS 5 AND 6
DETAILED DESCRIPTION! OF WORK:
Right Side:
Left Side:
Lot No.5 AND 6
Block No. 6
REMOVE EXISTING SHINGLE ROOFING SYSTEM AND INSTALL NEW METAL ROOFING SYSTEM
4/12 SLOPE1
CONSTRUCTION INFORMATION:
11HVAC LJ Gi s Tank
Electric 0 Plumbing
Total Sq. Ft of Construction : 4400
Cost of Construction: $ 22,610
Gas Piping _ Shutters
Sprinklers Generator
S Ft. of First Floor: _
Utilities: Sewer Septic
QWindows/Doors
R1Roof /12 Roof pitch
Building Height: 12'
OWNER/LESSEE:
CONTRACTOR:
NameRALPH WILLIS !
Name: RICARDO LARA
Company: ELITE ROOFING SOLUTIONS, INC
Address:5409 BUCHANAN DRIVE
Address: 812 SE LINCOLN AVE
City: FORT PIERCE j State: FL
Zip Code: 34982 Fax:
City: STUART State: FL
Phone No. 772-286-0033�
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
II If value of construction] is $2500 or more, a RECORDED Notice of Commencement is required. I
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION':
DESIGNER/ENGINEER: _Not Applicable
Name:
Address: I
City: I State:
Zip: Phone !
I
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: f
City: i
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone: I
I
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 Ow ers 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 arelexempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fen ces,lwalls, 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 t•rst inspection. If you intend to obtain financing, consult w' lender or an attorney before
commp t ng Wgrk 9�rding your Notice of Commencement.
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Signat a of Owner/ Lessee/Contractor as Agent for Owner
gnature of Contractor/License Holder
STATE OF FLORIDA
/h `9' -
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 11 day of M A-/Gtl 20 If
this day of 1W,*� , 20 /� by
�tcai40 L/¢/t� I
Ae� nr,4 L*r*
Name of person making statement I
Name of person making statement
Personally Known OR Produced Identification
Personally Known X OR Produced Identification
_
Type of Identification . I
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
�p yA Theresa Anne s o
Commission No. ss' a r i
Theresa Anne Fasa
Commissioeal)
c 6TARY PUB
NOTARY PUBLIC
STATE OF FLORIDA!
STATE OF FLORIDA
Co m&�.Com
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