HomeMy WebLinkAboutBUILDING PERMIT APPLICATION0
ALL
APPLICABLE IN O MU T BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Numb r•
a��r�0�S6NDIV
RECtIVED
Building Permit ApplicatioLesien--
018
Planning and Development Services partment
Building and Code Regulation Division nty, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT, ,'p TION "s .
a
Address: 7500 BELLEAIR AVENUE, FORT PIERCE
Legal Description: LAKEWOOD PARK- UNIT 7 - BLK 81 LOTS 8 AND 9
Property Tax ID #: 1301-607-0287-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION OF lNORK
TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP METAL
PANEL ROOF SYSTEM OVER OWENS CORNING WEATHERLOCK TILE & METAL
UNDERLAYMENT, FLAT PORTION: INSTALL POLYGLASS MODIFIED BITUMEN ROOF SYSTEM.
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$TRUCTfON INFORMATION
Adclitional work to e e orme under this permit — check
11HVAC 11 Gas Tank Gas Piping
a
apply:
_ Shutters
❑ Windows/Doors
11 Electric 0 Plumbing
Sprinklers
Generator
W1 Roof 3/12 Roof pitch
Total Sq. Ft of Construction: 2,800
S Ft. of First Floor: 1,248
Cost of Construction: $ 6,500.00
Utilities:In
Sewer
Septic
Building Height: 1 STORY
WN'ER/LES'SEE� :y ',,'
CONTRACTOR. ,
Name SERGIO LOPEZ
Name:
Company:
Address: 7500 BELLEAIR AVE
City: FORT PIERCE State: _
Address:
Zip Code: 34951 Fax:
City: State:
Phone No. 772-353-9671
Zip Code: 34982 Fax: 772-468-8397
E-Mail:
Phone No. 772-466-4040
Fill in fee simple Title Holder on next page ( if different
E-Mail: NADINE@JATAYLORROOFING.COM
from the Owner listed above)
State or County License: CCC1325895
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION
LIENLAZW INFORMATION
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DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ of Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ of Applicable
BONDING COMPANY:
_ of Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
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, 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.
V� < Ipte
Signa&W of wne essee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 8TH day of JUNE 20_ by
this day of , 20_ by
SERGIO LOPEZ
Name of person making statement
Name of person making statement
Personally Known xx OR Produced Identification
Personally Known xx OR Produced Identification
Type of Identification
M
Type of Identification
Produced `ti�1�\\AE oe,�s
Produced
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o��M1SSI0N�
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° p �bor q o�
(Sig ature of Notary Public- State of FfoAclii
(Signature of Notary Public- State of Florida )
y ^, #FF 936050 ;• Q
Commission No. FFs3soso-,(ye�k�yeo„��hN, sv Q`
Commission No. (Seal)
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ZONING
SUPERVISOR
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DATE
d
RECEIVED
�t
DATE
COMPLETED
Rev. 8/2/17