HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONN
.:ALL AP, PLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Datedal Permit Number:
SCANNED
_•_ By RECEIVED
st. Lucia County
Building Permit Applicati n JUL 2 7 2018
Plan ng and Development5ervices ST. LUGM CQUhtY, Permitting
Build 7g and Code Regulation Division
2300� irginia Avenue, Fort Pierce FL 34982
Pho : (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PER
I'I IT APPLICATION FOR: Roof - Sr VzkA—
PROPOSED
IMPROVEMENT LOCATION:
Addre Ids: _f n�adrl Ave.—+Bonk Samct� � l ACC
Legal d escription: RI X' Y�C � 3 ` 131 k 5 Lok V3
Propel Tax ID #: SW 01 _ 51 5 - Mq0 Qm - b Lot No.� 3 _
Site Pl [ n Name: N/A Block No.
P
Name: N/A
Front N/A Back: N/A Right Side: N/A Left Side: N/A
DETA,IILED DESCRIPTION OF WORK:
�SV �� \-c. ow -'a r' cx dQwin �'t-o
ram,;' w�'�-1� o� S uund�Ir� rn�,n-� •S�In l.c 0, nd, -%. �k0'i. rotF_ v�(f A.VX Lim
r
CONSTRUCTION INFORMATION: �:)111
Additi nal worKto be ertormed unoertnis permit- cnecK au inat apply:
VAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
i
❑_, lectric 0 Plumbing, '� Sprinklers Generator Roof 1Z Roof pitch'
Total Ft of Construction: 51n1a 1C 6*9ak S . Ft. of First Floor: N/A
12 /2
Cost o Construction: $ I i 515 M Utilities: Sewer 0Septic Building Height: N/A
OW
'ER/LESSEE:
CONTRACTOR:
Nam
II
Name: Christopher Collins.
�s:e_0.C_ Ave-
Addre
Company: Collins Roofing Inc.
brk Swntww,, State: _FL
le:-3962 Fax: N/A
No. N/A
City:
Zip Cc
Phone
Address: P.O. Box 12867
City: Ft. Pierce State: FL
Zip Code: 34979 Fax: 772-489-6505
N/A
E-Mai
Phone No. 772-201-1352
f6e simple Title Holder on next page (if different
Fill in
E-Mail: collinsroofinginc@gmail.com
from t
e Owner listed above) J
State or County License: CCC-058011
If valudjlof construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: ilk,
DESIGNS
Name:_
Address:
City:
Zip:
GINEER: - W1 Not Applicable
State:
FEE SIMPLE TITLE HOLDER: rNot Applicable
Name:
Address: P.O. Box'12867
City:
Zip: Phone:
MORTGAGE COMPANY: r Not Applicable.
Name:,. T,.
Address:
City: ' Ft. Pierce State:
Zip: Phone:
BONDING COMPANY: r Not Applicable
Name:
Address:
City:
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 they 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 coricu'rrency review: ri o n � itions,
accessory" stru imming pow fences, walls, signs, screen rooms and access ses er non-res'dential use
Zre
G TO OW . our failu to Record a Notice of Commen
ients to r property. Notice of Commencemren
be f�Vajpcorre=naycour
ectiOntend to obtain financinci Notice of Commence
ment ma ult in your payi g twice for
be re r d and posted n the jobsite
It wi re der ox a"ttor eV before I i '
f ' '
STATE icF'FLORIDA STATE OF•FLORIDA' ;
COUNTY OF '"COUNTY OF _ "S',+'
The forgoing instrument was acknowledged before me
thisday of /J 26LE-by
Lra bpi lm ��►�'1
Name, of person m mg statement
Doro—ii. v—...n-• , _ R Dr -A ir-4 1,4—tifi.- -inn
Type of�lde"aria' ion CATHY J ROBERTS
cots` P&el�:
Produc �d.• Florida
o Commission # FF 221708
I1 c:F ftiy/9omm/xplr fay 10, 2019
(Signature of`Klbtary Pu-blio- Slate of'T-lorida)
Commission No. (Seal)
The forgoing instrument was acknowledged before me
this -z!q day of - 20_ -by
Name of person making statement
Personally Known FOR Produced Identification
Typo of Identification
Produced .
n1 A 1 _//-
(Signature k S d Iea-;te�ar� 1� to of Florida
r _ Commission FF 221708
Commission N=udhki
Expi� 1C; 201gonal-NataryAssn.
REVIEWS FRONT ZONING SUPERVISOR PLAN VEGETATION SEATURTLE 'MANGROVE
COUNTER REVIEW REVIEW REV REVIEW REVIEW REVIEW
DATE
DATE
COMPLETED I I I 7I&1 (1109
Rev. 8/2/17