HomeMy WebLinkAboutBUILDING PERMIT APPLICATION,j I -
i ALL APPLICABLE ,NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1
Date: 3 Permit Number:
CANNI0 RECEIVED
liJ U L ® Buding Permit Application
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division _
2300 Virginia -Avenue, Fort Pierce FL 34982
Phone (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
IIPERMIT APPLICATION FOR: Roof -
'PROPOSED IMPROVEMENT LOCATION:
OF LOT 230 SHEENS
'ess: ���i1 moo_ o o_ `l�� \ t C,�`t �1�P �l LAT OF WHITE G TY RUNS 00 DE 001 MIN 09 SEC E 184.35 FT,
'TH S 89 DEG 54 MIN 58 SEC E 446.65 FT, TH N 00 DEG 02 MIN 00�
Description: SEC W 1.23 FT, TH S 89 DEG 55 MIN 44 SEC E 32.65 FT TO POB, TH
CQNT S 89 DEG55 MIN 44 SEC E 153.8 FT; TH S OODEG-02 MIN 21
SEC E 133.08 FT, THN 89 DEG 56 MIN 31 SEC W 153.8 FT, TH MOO,,
DEG 01 MIN 09 SEC W 133.11 FT TO POB (0.47 AC) (OR 661-460) ,'
ierty Tax ID #: 34025-.5C)2`029Io-1 0 - E
- - Lot No.
Plan Name: N/A Block No.
Rct Name: N/A
Jacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
DETAILED DESCRIPTION OF WORK:
W,tl �Za,� 0 -1tvl n �lnl� �e vcc �.V' ��lal
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- GUU)� � o � C�VVe 4 c�, fie, W �V� Ia
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CONSTRUCTION INFORMATION.
Ad.ditional work toe nerformed under this permit -check a apply:
E1HVAC El Gas Tank Gas Piping _ Shutters a Windows/Doors
❑ Electric ❑ Plumbing Sprinklers ❑ Generator Roof Roof pitch
Totl I Sq. Ft of Construction: �-�vv Sq. Ft. of First Floor: N/A
Cot of Construction: $ I Q� 1 utilities: Sewer OSeptic. Building Height: N/A
OWNER/LESSEE:
CONTRACTOR:
Naiine 3, Q,
Name: Christopher Collins
Company: Collins Roofing Inc.
Addlress:
City: Stater
Address: P.O. Box 12867
Zip, ode: Fax: N/A
City: Ft. Pierce State. FL
Phone No. N/A
Zip Code: 34979 Fax: 772-489-6505
E-Mail: N/A
Phone No. 772-201-1352
E-Mail: collinsroofinginc@gmail.com
Fill in fee simple Title Holder on next page ( if different
State or County License: CCC-058011
from) the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
_SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: NIF_ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: Ft. Pierce State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address: P.O. Box 12867
City:
Address:
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 A nts.
The following bui p ications ar exempt from undergoing a full c urrency review: roo ,
accessory s ctures, s ing pools, fences, ails, signs, screen rooms a accessory uses to ernon-residential u
WAR G TO . Your failure to cord a Notice of Co encement m r in y ur paying twice r
im oveme s t prope No ce of Commence nt must be r c d and ed on the jo site
ohe it �s orctioor 'yI� to r Notice of Comme ceme t su
mm nIt r o atto�ey befo
as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The fo going instru e t was acknowledged before me
this � day of 20,L�' by
VfS
Name of person making statement
Personally Known OR Produced Identification
Type of Ident' ' . t' —
Pro ce IN
�• = Notary Public�- t3 r da
•: issionmf� #GG 16�9025
My Comm. Expires Dec 18, 2021
one o a sn. .
(Sig a )
Commission No. (Seal)
der
STATE OF FLORIDA
COUNTY OF
The for oing instr t was acknowledg efore me
this T day of 20 by
If
Nfaitne of person making statement
Personally Known OR Produced Identification
Type of Identification
BELINDADARDEN
; Notary P tic— State of Florida
mission # GG 169025
M Comm. Ex fires Dec 18 2021
i fY 'irYe o�4A��9rgvv�t ion l a�f11oricla )
Commission No.
(Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE'
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
j
RECEIVED
DATE
COMPLETED
Rev. 8/2'/17