HomeMy WebLinkAboutBUILDING PERMIT APPLICATION1
ALL APPLICABLE INFO MU1ST E COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date:-�� 6'�I 1 I Permit Number: �A6 4-10 11
SCANNED
I Or St [luelprv9nty RECEIVED
Building Permit Applicatio APR 0 4 ?.D18
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 46�!-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof= 6��y�o.1�R
PROPOSED IMPROVEMENT LOCATION:`
Address: 5504 Eagle Dr. Fort Pierce, FI. 34951
Legal Description: Holiday Pines S/D Phase I Lot 96
Property Tax ID #: 1312-500-0097-000-2 Lot No.
Site Plan Name: I Block No.
Project.Name:
Setbacks Front Back: Right Side: Left Side:
I
DETAILED DESCRIPTION OF WORK:
Tear off existing sire and flat roof. Re -nail plywood deck to code. Install Mid -States underlayment FL17401 on slope
install OC Tru of Sphinales FL10674-R13. Ins all Elastoflex SAV as base and Elastoflex SAP as cap on flat FL1654-R22
CONSTRUCTION INFORMATION:
Additional work to be nprtormed under this permit —check
11HVAC Gas Tank Gas Piping
all
apply:
Shutters
[]Windows/Doors
Electric 0 Plumbing
[]Sprinklers
Generator
W1 Roof 7: 2 Roof pitch
Total Sq. Ft of Construction: 37 sq.
of First Floor:
SInEl
14,965.00
Cost of Construction: $ I
i
Utilities
SewerSeptic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Ae .4
Name: 1ZA 120 (OA.
Address: C UA �l ,,
1
Company: 1 � 'L f o .v c
City: q007 15A S State: _
Address: 77 0 (b '1)(Y Ia N
Zip Code: 3 cftfT Fax:
City: qo v7 t,-A-e State:
Phone No. `" 9, - A $S ,
Zip Code: I Fax: 77 X y(o � 2-Z4 7
E-Mail: !
Phone No. `7 7 a- - fib. �' 7 T-7 Z)
Fill in fee simple Title Holder on next page ( if different
E-Mail: "{ 141(damg !Ih ,¢ r .CP�4v
from the Owner listed above) I
State or County License: UK- Q S" k Q 3
If value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEI A,WAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: —No ! t Applicable
MORTGAGE COMPANY: _ Not 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
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 ermit holder to build the subject structure
which is in conflict with any applicable HomeiOwners 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, 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 recording your Notice of Commencement. /1 A
`Signature of -Owner/ Lessee/Agent Signature Contr ctor/License Holder
STATE OF FLORJ,QAi ! STATE OF�RIDA
COUNTY OF JL Lucie COUNTY OF ky a-e
The for in The forgoing instru ent was acknowled ed efore me g g instru nt was acknowledged before me
this day of 20 f,Lby this 3 ay of � nor i , 20 by
NorrOPW Xriq J30L5C-0rnbP— CkrtS+o
(Name of person acknowledging )Owner/Lessee/Agent Printed Name (Name of per on acknowledging Contractor's Name
-T ve" WS V,- —o—
(Signature of Nbtary Public- State of Florida )
I
Personally Known OR Produced Identification
Type of Identification Produced_ f=1ti 17ri!vtr`y Li fie��
Commission No. C;77 /SS 9b4gygss, Tip�� vv. Sutton
� , NOT lY PUBLIC
skSTATE OF FLORIDA
Revised 07/15/2014 4 `igil'o Expires 3/20/2022
(Signature bf Notary Public- State of Florida )
Personally Known f_ OR Produced Identification
Type of Identification Produced
Commission No.
TimQQtX Sutton
NOTARUBLIC
STATE OF FLORIDA
Expires 3/20/2022
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