HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
.11-1$ SCANNED "
Dat Permit Number:
�� _ .
.- RECEIVED
Sit. Lucie County
�,, s•ur �����,���," Building Permit Application JUL L 31 2018
Pla ing and DevelopmentServices ST. Lucie County, Permitting
Buil ing and Code Regulation Division
230 Virginia Avenue, Fort Pierce FL 34982
Ph �ne: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PER
IT APPLICATION FOR: Roof
"PROPOSED
:IMPROVEMENT LOCATION. ,
Addr ss: 10701 S Ocean Dr 620
Legal Description: Venture Out - Section C - Lot 21 ( or 1295-1302:3289-879:38202099
Site
y Tax ID #: 451180500210005
i Name:
Name: 10701 S Ocean Dr 620
cs Front Back: _
Right Side: Left Side:
Lot No.21
Block No.
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e ✓� a w✓� x ✓� l�� � ,ry � i q � /2 r„
",r DESCRIPTION
CO STRUCTI,ON INFORMATION =
Additional workto a ne orme under tis permit—checka that apply:
[jHVAC0 Gas Tank ❑Gas Piping ❑ Shutters ❑ Windows/D ors
11 Electric ❑ Plumbing Sprinklers ❑ Generator Roof Roof pitch
Total,Sq. Ft of Construction: 1900 S . Ft. of First Floor:
Cost f Construction: $ UtilitiesInSewer Septic Building Height:
OUV'NER/LESSEE
"
CONTRACTOR:-
Name'
Address:
City'.
Zip
Pho
E-M
Fill iri
from
Ann Marie Barrell
Name: Matt Drozd
S Ocean Dr 620
Company: Diversified Roofing Solutions Inc
Address: 450 S Old Dixie Hwy #1
I1ss:ensen Beach State:FL
ode: 34957 Fax:
'e No.
City: Jupiter State: FL
Zip Code: 33458 Fax:
Phone No. 561.841.5676
Iil:
fee simple Title Holder on next page ( if different
the Owner listed above)
E-Mail: geris@diversifiedroofingfl.com
State or County License: CM 330205
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DE IGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Na e:
Name:
Ad ress:
Address:
City: State:
City: State:
Zip l Phone
Zip: Phone:
FEE
SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Na
e:
Name:
Adc
Tress:
Address:
Cit 't:
City:
Phone:
Zip: Phone:
Zip:
OWP lER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I cert that no work or installation has commenced prior to the issuance of a.permit.
'
St. Lu . a County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
in Home Owners
which:s conflict with any applicable Association rules, bylaws or and covenants that may restrict or prohibit such
struct' re. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In con' ideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in acc rdance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The f6lowing building permit applications are exempt from undergoing a full concurrency review: room additions,
acces ory 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
'vements
impr to your property. A Notice of Commencement must a recorded and posted on the jobsite
befog the first inspection. If you intend to obtain financing, con u with lender or an attorney before
comr lencinRwork or recording our Notice of Commenceme t.
i
Signi ure of Ow er/ Lessee/Contractor as Agent for Owner
Sign to f tractor/License Holder
STA E OF FLORIDA
COL NTY OF f4jw.
STATE F FLORIDA
COUNTY OF Rbaim, 6-a4- a
The f )rgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of20( by
this ,;t& day of 'a , 20 f � by
u u
V* A Tt "D P-0 a �
Name of person making statement
Name of person making statement
Personally
Known 4-� OR Produced Identification
Personally Known !—�_ OR Produced Identification
Type
b f Identification
Type of Identification
Produced
Produced
(Signature
of Notary Puf Flo ' U�1=
I K $H
(Signature of Notary Pu '
��"Y"�
Com
RT
fission No. ay, ;� MY CVADWI)SSION # GG006600
.... GEf31 K SFiUBEI$T
Commission No. _ :`= MY CO0@*ON # GG006600
q„ ,, EXPIRES October 07, 2020
", :; EXPIRES October 07, 2020
FloridMotarySorvJa.rnm
(407) 398.0153 Flondallota ryServJce..com
REV
EWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
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COUNTER
REVIEW
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COMPLETED
Rev. 8/
/17