HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
5/23/2018 S(OANNED Permit Number: O
BY
• L__R1 �D�`�
BuildingPermit Application II pp 2098and Development Servicesand Code Regulation Division Permitting
23(,110 Virginia Avenue, Fort Pierce FL 34982 __ .._..
Ph,ne: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
lid
PROPOSED IM`PROVEM'ENT'LOCATION:
02 ILA.
Description:
PP. ro'°erty Tax ID #: 1301-111-0001-000-5 Lot No.34
Sited Ian Name: p 186 Macleod Block_No.
II
Project Name: P186 Macloes
Set tl acks Front Back: Right Side: Left Side:
DET XILED,DESCRIPTION�,OF WO R K1.;
Re+f 13 Squares with 26 Gauge 5v'Metal FC+L rl-'a,C(_q.l
CONSTRUCTION INFORMATION:
`AdOitional work to e e orme under this permit— check a apply:
�II HVAC F] Gas Tank ❑Gas Piping _ Shutters I] Windows/Doors
ill Electric 0 Plumbing Sprinklers E Generator R1 Roof 3/12 Roof pitch
Total) Sq. Ft of Construction: 1300 Sc Ft of First Floor:
Cos of Construction: $ 6900.00 Utilities: Sewer E]Septic Building Height:
0W"NER/LESSEE
_ � _ . ,
CONTRACTOR:
Nary
Add'
City;
Zip
Pho
E-1V
Fill!I
fro
Ile Eileen Macleod
Name: Chris Dutruch
Company: My Affordable Roof
Address: 1585 Kennesaw Dr
ess:34 Arobles Del Norte
For Foerce State: fl,
ode: 34951 Fax:
ii a No. XA y i�,m
ail:
City: Claremont State:FL
Zip Code: 34711 Fax:
Phone No. 772-206-3344
fee simple Title Holder on next page ( if different
' the Owner listed above)
E-Mail: wendell@myaffordalberoof.com
State or County Licenser CCC1331305
If val" a of construction is $2500 oremore,'a RECORDED Notice of Commencement is required.
SU�PPLEMENTAL_CONSTRUCTION LIEN LAW INFORMATION:
DE
Na'�
Add'
IGNER/ENGINEER: Not Applicable
e:
MORTGAGE COMPANY: _ Not Applicable
Name:
.--Address:
ress:
Cit�i;
: State:
City: State:
Zi ,
Phone
Zip: Phone:
FEE
SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
Cit
_
Name:
Address:
City:
Zip: Phone:
zipPhone:
OW ER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as.indicated.
I cer ify that no work or installation has commenced prior to the issuance of a permit.
St. L cie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
whirl 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 co l sideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in ac;�ordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The fpllowing 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
WA. KING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
imp;",,ovements 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
com!'"'%nencine work or recording vour Notice of Commencement.
ature osier/ Le'9seVJ"Contractor as Agent for Owner Signature of Contr-actor/License Holder
TE`OF FLORIDA i ` STATE OF FLORID l
JNTY OF l �C�SL� COUNTY OF l�
Th 10lforgoing instrument was acknowledged before.me The forgo' nstrum t was acknowledged before me
thi tcy of % v\^, 20_!,by this �'�ay'of 20 1i'�by
Name of person aking statement Name of person making statement
Per, onally Known �R Produced Identification Personally Known OR Produced Identification
Typle of Identification Type of Identification
Pro uced Produced
(Si °nature of Notary Pu Mate opp% a�jne (Signature of Notary PAIC-State %Florigla )
WCS1.0b
NOTARY I3BLIC cR Berta enne
Co mission No. STATE egI ORIDA �,NOTARY PUBLI
jCommission N Comm# FF952012 OF FComm# FF952012
Expires 1120/2020 ri. __ _ ,�
R11IUIEWS COUO TER REVIEW S REVIEWUPERVISOR I REVIEW PLANSVREVIEEGETWON SEREV EWLE REV EWVE
RECEIVED
COMPLETED
Rev. /2/17