HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL
2300
.ICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number: ou�
SCANNED
BY RECEIVED
Building Permit Application St-LudeC00b,
and Development Services AUG 17 2010
and Code Regulation Division Permitting Department
ginia Avenue, Fort Pierce FL 34982 St. Lucie County
(772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxxxxxxx
PER
I IT APPLICATION FOR: Roof
;FRO 1,
SED IMPROVEMENT LOCATION:'
Addre 90 SAN LUIS OBISPO, FT. PIERCE, FL 34951
Legal Description: 134 39 - SPANISH LAKES COUNTRY CLUB VILLAGE
I
Prope
Site P
:v Tax ID #: 1301-111-0001-000-5
n Name:
Name:
Lot No._
Block No.
Setba Inks Front Back: Right Side: Left Side:
D'ET ILED6-DESCRIPTION OF WORK
REM VE EXISTING ROOF & REPLACE ANY ROT ! V V c
INSTAL LL. ASTM-226 30# UNDERLAYMENT
INSTALL 26 GA METAL ROOF SYSTEM fl-0V1 n /;
a
CON RUCTION INFORMATION.
A 11 ona wor to a e orme un er t is permit — c ec aapply:
Q
11
Total
Cost o
AC Gas Tank Gas Piping _ Shutters Windows/Doors
ctric 0 Plumbing Sprinklers ElGenerator Roof
Ft of Construction: 1,600 S Ft. of First Floor:
onstruction: $ 7,950 UtilitiesSewer Septic Building Height: _
°OWNERJLESSEE;
CONTRACTOR: -
Name
Addre
City: Miami
Zip Co
Phone
E-Mail
Fill in
from the
VjVynne Building Corp / Mary Ann Shanley
Name: JOE BAKER
12804 SW 122nd Ave. / 90 SAN LUIS OBISPO
Company: BIG LAKE ROOFING &REPAIRS
Address: 2699 NW 16TH BLVD.
City: OKEECHOBEE State: FL
Zip Code: 34972. Fax: 863-763-7662
Phone No. 863-763-7663
E-Mail: BIGLAKEROOFING@YAHOO.COM
Il
/ Ft Pierce State: FIL
�e: 33186 / 34951 Fax:
�lo. 201-213-5287
flee simple Title Holder on next page (if different
Owner listed above)
State or County License: CCC046939
If value lof construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPEiVIENT.AL
CONSTRUCTION LIEN LAW INFORNiAT10N:
DESIG
Ni
Address:
City:
Zip:
ER/ENGINEER: Y, Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
�� State:
Phone:
'1
City: State:
Zip: Phone:
FEE SI
Name'
Addre
city:
Zip:
I VIPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
s:
Address:
City:
Phone:
I
Zip: Phone:
I certify; that no work or installation has commenced prior to the issuance of a permit.
St. Luci County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which i in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structu ,e. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In cons eration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in acco IOance 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,
accessc� y structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
'WARP ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impro' ements to your property. A Notice of Commencement must be recorded and posted on the jobsite
befor( the first inspection. If you intend to obtain financing, consult with lender or an attorney before
comm ncine work or recordine vour Notice of Commencement.
1
Signat4e of Owner/ Agent/ Lessee
Signature of Contractor/License Holder
RIDA STATE OF
RIQ
STAT4OF 1
OFO-P ,� I COUNTY OFOLJ� - P
ThMRa
instru nt was acknowledge b fore me
thiof 20 _� !NY
(Name]',of person acknowledging)
(Signal:'lure of Notary Public- State of Florida )
Person Jily Known OR Produced Identification
Type o identification Produced
The forgo' instru ant was acknowledge fore me
thi of� 20' y
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification roduced
Commi''sion No. 41 .: HEfflMREDWARDSON Commission No.
Q-2 MY COMMISSION # GO 215165
Bonded Ttn Notary Public Underwriters
07/ 15/201
HEATHW,MWARDSON
MY COMMISSION # GO 215185
EXPIRES: May 21, 2022
onded Thu Notary Public Underwriters
REVI
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SUPERVISOR
PLAN
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REV
REVIEW
REVIEW
REVIEW
DATE
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COMPLETE
INITIAI
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