HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL ,(PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: rP Permit Number: 1 60
h
P
:�U;r�\ � NED
f@�
RECEIVED
Building Permit pp�(ication
A U G 16 2018
ing and Development Services
ng and Code Regulation Division
Virginia Avenue, Fort Pierce FL 34982
e: (772) 462-1553 Fax: (772) 462-1578
ST. Lucie CounW, Permitting
Commercial Residential
PER I/IIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line tdcs-,�,
PROPOSED IMPROVEMENT LOCATION =
Prop2IrtyTax ID #: f N�2-�5— C�3�1 G -g Lot No. ZiA
Site illIlan-Name: Block No.
Proj ct Name:
Setb cks Front Back: Right Side: Left Side:
Itional work to be ertormed under this permit —check a aoo v:
JHVAC Gas Tank ❑Gas Piping
lElectric _ 0 Plumbing Sprinklers
UShutters DWindows/Doors
12Generator WRoof ® Roof pitch
Sq. Ft of Construction: ' I (/ is ' S . Ft. of First Floor:
)f Construction: $ q7� Utilities: L a, Sewer 0 Septic
Building Height:
OV1/�NER%LESSEE
;CONTRACTOR .
Na
Add
�e Ob
Name: Christopher Dutruch
ess: l0
'Company: MAC MAR, LLC / My Affordable Roof
AiState: 4C3/-
City
Address: 1585 Kennesaw Drive
Zip,
ode: 3 419 (/% Fax:
City: Clermont State: FL
Pho;I�e
No. `771.'^' 3
Zip Code: 34711 Fax: 772-905-8694
E-Mail:
Fill i
front
JII
Phone No. 772-206-3344
E-Mail: wendell@myaffordableroof.com
State or County License: CCC #1331305
ri fee simple Title Holder on next page ( if different
the Owner listed above)
Ivdj4C LPI wna«ucavn is pcauu or more, a KtwKutu notice oT commencement is required.
SUPPLEMENTAL
CONSTRUCTIO WbEN LAW INFORMATION:
DESIGNER/ENGINEER:
Named
Addr Iss:
City: ��
Zip:
'.III
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
State:
ll Phone
FEE SIMPLE
Nam
Address:
City: II
Zip: II
TITLE HOLDER: _ Not Applicable
i
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Phone:
I
Zip: Phone:
OWNEk/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify Ihat 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 � conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structur Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In considderation of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordlance 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,
accessorl� structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before Ithe first inspection. If you intend to obtain financing, consult with lender or an attorney before
commehcing work or recording your Notice of Commencement.
r as Agent for Owner
STATE' OF FLORIDA COUNTY OF
The forgo�g instru ent as acknowledg d before me
this day of 207by
I' Name of person_p3aking statement
Personally Known OR Produced Identification
Type o I Identification
Produced
(Signature of NoL
tate 0ffklA4f�i I. a ITTA
—"
Notary Public -State ofFlorida
Commission No.Commisl FF 240619
My Comm. Expires Jun 16;2019
� Bonded through National Notary Assn.
I
REVIEWS FRONT ZONING SUPERVISOR
I� COUNTER REVIEW REVIEW
RECEIVED
DATE
COMP ET
Rev. 8/2/17
Signature of Contractor/License Hol er
STATE OF FLORIDA
COUNTY OF 0 re
The forgoing instrum nt as acknowledged before me
this day of Cl C. 201Z by
Name of persgperadking statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature •f is BPublic-1SM@WfloMb1P1N
Notary Public State of Florida
Commissio +' Commission # FF 2'9fl °11'°Pyc Expires Jun d19
Bonded through National Notary Assn.
PLAN VEGETATION SEA TURTLE MANGROVE
E REVIEW REVIEW REVIEW