HomeMy WebLinkAboutBUILDING PERMIT APPLICATION_ L
►LL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/21/2018 Permit Number:
Build
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
�l �Jnt =RECEIVEDPiermit Application
;ommercial X Residential
PERMIT APPLICATION FOR: Roof El
RROPOSED IMPROVEMENT LO:CATIQN
Address: llA3 (\=\P,S B\\)d )P-A" 'I
Legal Description: NETTLES ISLAND INC, A CONDO -SE
AND PRO-RATA SHARE IN COMMON ELEMENTS (OR 1
Property Tax ID #. 4502-501-1380-000-5
Site Plan Name:
Project Name: Ross Residence
Setbacks Front Back: Righ
Tear off, Install underlayment, Install accessory
❑HVAC ❑ Gas Tank ❑Gas Piping
❑Electric ❑ Plumbing []Sprinklers
Total Sq. Ft of Construction: oo
Cost of Construction: $ _�% Ut
II PARCEL 1193
): 3370-2907)
Is and metal panels.
I Generator
of First Floor: _
Sewer ❑Septic
Lot No.
Block No.
Windows/Doors
21 Roof Roof pitch
Building Height:
Y
:01/1/NER/LESSEE `i „
•
�CO(VTRACTOR
r..
.. ro .. n ., .
Name Tdw,mg liOSC
Name: J.,avn Haf t(nt2
Address: 11613 ` Ntttlej glyd. •
Company: Total Roofing Systems Specialist
City: den Se ^ B-e-r-C State:FL
Address: Z 01 SE 'D Z--- re
Zip Code: 34957 Fax:772-872-8083
City: s vox'r State: FL
Phone No.772-872-8030
Zip Code: 34997 Fax: 772-872-8033
Phone No. 772-872-8030
E-Mail:Samira@totalroofingsystems.net
Fill in fee simple Title Holder on next page ( if different
E-Mail: Permit@totalroofingsystems.net
from the Owner listed above)
State or County License: CCC1330788
It value or conszruction ►s >csuu or more, a KtGUKUtU Notice of Commencement is required.
DESIGNER/ENGINEER.
_ Not Applicable
Name:
Address:
I
City:
State: 1
Zip: Phone
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
Name:
Address:
I
City:
I
Zip: Phone:
I
ORMQTIQN
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is I ereby 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 Associai ion 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 Buildirilg 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
impr vements to your property. A Notice of Commencement must be recorded and posted on the jobsite
befor he first inspection. If you intend to obtain financing, consult with lender or an attorney before
corns inl; wok or recording vour Notice of Commencement.
er/ Lessee/Contractor as Agent for Owner
COUIN I MI
COO
The Jorgoing ins rument was acknowledged before me
thi " day of 201% by
Name of person making statement I
Personally Known)C?!!;Z OR Produced Identification
Type of Identification
Produced ' I
�J
(Signature of Notary Pu li State of Florida )
Commission N
REVIEWS
o''" "°v. BONNIE LOVITT
my comml.q
COUNTER
17, 2021
SUPER ISO
Signature oN�ontractor/License H
ATE OF Fi
WNTY OF
The forgoing iUhO
nt was acknowledgbefore me
this day of� 2O11 by
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary P Yb ' - State of Flo ida )
Commission No. (Seal)
BONNIE LOVITT
`= Y
E PIRES September J7,2021
PLANS VE_ I SEA TURTLE I MAN ROVE
DATE i
RECEIVED i
DATE l
COMPLETED 31��
Rev.8/2/17