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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APP Date: 05/17/2018 WIN Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 TO BE ACCEPTED Permit Number: u veerdr RECD &rxlirt� Application MAY 1 R..?o' Perrnito, g De aZZen )mmercial Residential X PERMIT APPLICATION FOR: Roof I G' P,ROPOSED:'IMPROVEME.IUT`LO.CATION`$ Address: 18705 Mach One DrPort St Lucie, FL 34987 Legal Description: AERO ACRES BLK 1 LOT 13 (2.03 AC) (OR 2514-2646) Property Tax ID #: 3215-801-0020-000-4 Site Plan Name: Project Name: -by OinA UAS cCe Setbacks Front Back: Right Side: Left Side: ,�"ILED DESCRIPTION OF WORK Tear off, install underlayment, Install accessory metals and metal panels. Lot No.13 Block No. 1 CONSTRUCTION INFORMATION a t, ��... R ,. ,_. •.� Additional work to a er orme un er t is per it- c ec a apply: E1HVAC 13 Gas Tank ❑Gas, Piping tn _ Shutters Q Windows/Doors 11 Electric 0 Plumbing ❑Sprinklers E l Generator Roof Roof pitch Total Sq. Ft of Construction: 3� I S . Ft. of First Floor: 1 Cost of Construction: $ �C1 1X0 0 O(� I UtilitiesSewer Septic Building Height: I 01NNERALESSEE �, , f TRACTOR Name Andrew S Bruhn And Evangeline G Bruhn I Name: Juan Martinez Address:18705 Mach One Dr I Company: Total Roofing Systems Specialist City: Port St Lucie State:FIL Address: 3201 SE Dominica Terrace City: Stuart State:FL Zip Code: 34997 Fax:772-872-8030 I Phone No.772-872-8030 Zip Code: 34997 Fax: 772-872-8033 Phone No. 772-872-8030 E-Mail:Samira@totalroofingsystems.net I Fill in fee simple Title Holder on next page (if different E-Mail: Permit@totalroofingsystems.net from the Owner listed above) I State or County License: CCC1330788 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. r A SUPPLEI/NT�RuLL p�NE F 5 d DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: I Address: City: State: I City: State: Zip: Phone I Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: 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 ermit 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 approv plans, the Florida Building (Codes and St. Lucie County Amendments. The following building per 'applications are exempt from Undergoing a full concurrsd room ad I accessory structures, swi in pools walls, signs, s teen rooms and acce other non -reside tial use WARNING TO OW R: ur failure to Rec rd a No ice of Commen menin your paying ice for improvements t property. A Notice of Com encement ust bend posted on t e jobsite before the firs n ction. If you intend o obtain�financing,tn nsult r an attorney efore commencin or r recording your N ice of Cornmencemt. re of/b)kner/ Lessee/Contractor as Agent for STATE PF/f LORIDA COUN Y OF_ M kf-tl n Tr2= dged before me t20 by L' Name of person Ing statement Personally Known OR Produced Identification Type of Identification Produced Signg6re4Contractor/License Holder FLORIDA - OF M04' -I h T e f rgoing instrument was acknowledged before me i _?lay of 20_J'C by V G vl t✓l a (f 0 -C 2. Name of person m ng statement Personally Known OR Produced Identification Type of Identification I (Signature of Notary Public- State of Florida) (Sign ure otary P I, 'YP, SAMIRA Commission No. r /� e; � M. GONZALEZ l� "1''0 .< ONZALEZ Commission No. Ci' Notary Pu 1M to of Florida CommisSTon:�G197318 if w: ,` _ Not ry u lic - State of FloEida o`e Commission ; GG 19731 i3 of f ` My Comm. Expires Mar 18, 2022 �og ' My Comm. Expires Mar 18, 2022 Bonded through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17