HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO M ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i
Dale:SE
CANND Permit Number:
ICI BY -
St Lucie County RECEIVED
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Building Permit Application SEP 17 2018
Plning and Development Services ST. Lucie County, Permitting
4
Bul Ming and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Ph' ",ne: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XXXX
FPIEI�,IMIT APPLICATION FOR: Roof E.
Address: ss: 1 y (0 6vm %-o L � ✓�, 6. L n , Jen fen 6eG Lh F L ?415
Lega,�Description: 32 36 41/5 37 41 FROM SE COR OF SEC 32 RUN S 89 56 01 W ALG S LI OF SEC 749.94
Prop', rty Tax ID #: 3532-443-0001-000-1
Site an Name:
Projel',t Name: Herzog Residence
i1
Setbpcks Front Back:
Right Side: Left Side:
ear P install underlayment, Install accessory metals and metal panels.
ex sus -ring srungl'e-s 2 ,StOI'� MG -in n h0U-S 6
Lot No.
Block No.
Additilonal worKto be ertormed under this permit —check all apply:
E , VAC Ej Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
�r
❑ Electric ❑ Plumbing []Sprinklers ❑ Generator Roof Roof pitch
i
Total q. Ft of Construction: 2600 S . Ft. of First Floor:
Cost e Construction: $ 12,415.00 Utilities:Cn Sewer ❑Septic Building Height: 25 f+-
OVVfdER/LESS:EECONTRACTOR.
Name,
Address:
-City: 1-5e
Zi Code-
p
Phone
E-Main
Fill in
from t
I'
Name: J Ua.n Mart; r\oz
Company: Total Roofing Systems Specialist
Address: 3 2 O1 SE oo,-,n i ca Ten-ac,G
City: s
y 4,f6t'- - State: FL
Zip Code: 34997 Fax: 772-872-8033
Phone No. 772-872-8030
Samiratotalroofin s
E-Mail: @ 9 Ystems.net
State or County License: CCC1330788
q y 11P Cd- U-I bd L i .•, b a L- h
State:FL
I. 34957 Fax:772-872-8033
No.772-872-8030
�;Samira@totalroofingsystems.net
'I a simple Title Holder on next page (if different
e Owner listed above)
It value'Jot construction is $ZWU or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL-'.CON'STRUCTION
LIEN LAW INFORMATLON
DE IGNER/ENGINEER: _ Not Applicable
11
MORTGAGE COMPANY: _ Not Applicable
N e:
Name:
AC ress•
Address:
City: State:
II
Ci 'y: State:
Zi Phone
Zip: Phone:
FE
SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
N
A lldress:
_
: e:
Name:
Address:
City:
Ci
y:
Zil Phone:
III
Zip: Phone:
OWER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I ceI`, ify 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 the 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 cirisideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in a ordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
Theollowing 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
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
im '' 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 attorne_ �,r before
cor6mencing work or a rding your Notice of Commencement.
Owner/ Lessee/Ca ractor
OF FLORWA
TY OF v+ 1 e)
Owner I Signature
STATE OF FLORIDA
COUNTY OF h-1
cerise Hol
rgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
1'dayof 4cp alIh J-el 20-A by
this 1 May of -1e►� �r 201g by/1
7Name
�•oFki
lin,
of person mg statement
Name of perso making statement
ally Known OR Produced Identification
Personally Known 1/ OR Produced Identification
f Identification
Type of IdentificationEP
°°
w
ed
Produced
N'liI�
V U
L
-N
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Vl n ure of Notary Public- State of Florida) / (Signature of Notary Public- State of Fl&-&d
III
fission No. GrGr 19 73/,r (Seal) Commission No. GG• 1973W (Seal)
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I
R VIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
ED
CQMPLETED
Rev.' 8/2/17