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ALL A ,IPLICABLE INFO MUST BE COMPLETCiL r'1R APPLICATION TO BE ACCEPTED ` I I Permit Number: Mri 'cl o U
Date 3 AN 1�
BY
;s 4. L;, ee coin RECEIVED
Building, Permit Application JUL 05 2018
ing and Development Services
Per
ng and Code Regulation Division St. tLucie Cent
County
Virginia Avenue, Fort Pierce FL 34982
e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:,
Addre"'ss: 5209 Sunset BLVD Ft. Pierce FL 34982
Description: INDIAN RIVER ESTATES -UNIT 07- BLK 52 LOT 35 (MAP 34/02S) (OR 3907-1933)
Pro erty Tax ID #: 3402-608-0475-000-9 Lot No.35
Site Plan Name: 5209 SUNSET BLVD Block No. 52
Project Name: RE ROOF SHINGLE TO 5-V CRIMP METAL ROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
A itiona work to b n
orme under this permit— check a apply:
�HVAC Gas Tank ❑Gas Piping _ Shutters Windows/Doors
I ❑Electric ❑ PlumbingSprinklers Generator Roof = Roof pitch
T ital Sq. Ft of Construction:_ S . Ft. of First Floor:
C st of Construction: $ 17,500 Utilities:In Sewer []Septic Building Height:
,I
OWNER/LESSEE:-
CONTRACTOR:
lame Alycia Ann Germond
'Iddress:5209 Sunset BLVD
11111y: FT. PIERCE State:FL
ip Code: 34982 Fax:
Ione No.
Name: JAVIER SOLIS
Company: SOLIS ROOFING CONTRACTORS, INC
Address: 1033 SW DALTON AVE
City: PORT ST. LUCIE State: FL
Zip Code: 34953 Fax: 772-878-4097
Phone No. 561-662-6622
E-Mail: SOLISROOFINGINC @ GMAIL.COM
State or County License: CCC1330147
It -Mail:
y
ill in fee simple Title Holder on next page if different
prom the Owner listed above)
it
value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
low
SUPOLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESI
Naml:
Addr
City:
Zip:
NER/ENGINEER: x Not Applicable
Alycia Ann Germond
MORTGAGE COMPANY: Not Applicable
Name:JAVIER SOLIS
Address: 5209 Sunset BLVD
City: PORT ST. LUCIE State:
Zip: Phone:
�SS:5209 Sunset BLVD Ft. Pierce FL 34982
;T. PIERCE State:
;I Phone
9
FEE
Nam
Add
City:
Zip:
SAMPLE TITLE HOLDER: Not Applicable
fl
BONDING COMPANY: Not Applicable
Name:
Address:
SS:1033 SW DALTON AVE
I
City:
III Phone:
l
Zip: Phone:
OWN iR/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certi that no work or installation has commenced prior to the issuance of a permit.
St. Luci �I County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which i " in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structu e. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In cons deration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in acco;'dance 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,
access Iry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WAR ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impri �vements to your property. A Notice of Commencement must be recorded and posted on the jobsite
befor the first inspection. If you intend to obtain financing, consult with lender or an attorney before
com I encine work or recordine vour Notice of Commencement.
X
re of Own
r as Agent for Owner
ature of Colractor/License Holder
STAE OF FLORRR� l��l e� COUNTOY OF bIAAA
CO�l C.e-e
P. OF �� l
The nN
ing instr anent was acknowledged before me
thisday of 20L& by
ALYCIA ANN GERMOND
Name of person making statement
Per 'onally Known x OR Produced Identification
Typ oI of Identification
Pro uced
(I -I I
(Si �ature of Notary Pubic State of Florida )
tAav aue�. A-j�
Con,'mission No. ' c MY(6,,-- �2tSION#AF1181432
j N e EXPIRES: April 4, 2019
.,gTFpF F�pQ-\o Bonded Thru Budget Notary Services
EWS IFRONT I ZONING
COUNTER REVIEW
EIVED
COMPLETED
Rev. 8/2/17
The forgoing instr ment was acknowledged before me
this day of YV_ 20Z by
JAVIER SOLIS
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Produced
(Signature of Notary Pu I - State of Florida )
4o"a.::Ni" MARIA MAJANO
Commission No. * MSgw ISSION # FF 181432
EXP ES: April 4, 2019
'P'aTFoF F1.OA Bonded Thru Budget Notary Services
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