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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALLIA,PPLICABLE INFO COMPLETED FOR APPLICATION TO BE ACCEPTED Qa�[,,,e: . JUST BE Permit Number: SCANNED St Lucie count RECEIVED V. P/J'�' ri,g and De lopment Services Building Permit Application` SEP 17 2018 Builing and CodveeRegulation Division 236 1 6 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Permitting ,�IT APPLICATION FOR: Roof Site P an Name: Setb pks Front Back: Right Side: Left Side: Lot No. .^B|ockNu._______ � � 5 a list 't, Insfall accessory metals and metal panels. We are not touching rear .— —~ or lowpitch porch. Add /U 11E 0 Gas Tank E]Gas Piping Shutters VVindnma/Doors L~� El Plumbing []Sprinklers Generator i�~�Roof Roof pitch Total S Ft of Construction: 2900 Sq. Ft of First Floor: Name J!o1seph W Guettler Name: Juan Martinez AddresLI:4025 Delaware Ave Company: Total Roofing Systems Specialist Address: 3201 SE Dominica Terrace City: F�Irt Pierce State:FL Zip C04 34947 Fax: 772'-872-8033 City: Stuart -FL Phone No. 772-872-8030 E-Mail: Sam ira@totalroofingsystems.net E-IMai1:1,Samira@totalroofingsystems.net Fill in f'111 11 e simple Title Holder on next page ( if different from th I- Owner listed above) State or County License: CCC1 330788 itvalue c!construction m�zsVVurmore, aRECORDED Notice o7Commencement is required. CONSTRUCTIONSUPpPLEMENTAL , �,'L- EN c -7 �"LAW` INFORMATION DE, ER/ENGI NEER: xxx Not Applicable MORTGAGE COMPANY: Not Applicable �IGN 1� e: N a� �I Name: — Ad,Vress:. - Address: Cit. [ : Fort Pierce State: Y' City: Stuart State: Zip , Phone Zip: Phone: FE�:JSIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: LNot Applicable Na e: Name: Ad ress: 3201 SE Dominica Termce Address: City: Cit I' Zi p1l, Phone: Zip: Phone: OWN ER/ 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. � rie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure Home Owners Association bylaws that restrict or such whichIllis in conflict with any applicable rules, or and covenants may prohibit 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 acc" rdance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. I The fo'lowing 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 T impr11 vements to your property. A Notice of Commencement must be recorded and posted on the jobsite befod� the first inspectIOD'If you intend to obtain financing, consult with lender or an attorney before co encing work or <Corcling your Notice of Commencement. 00 Sign of Owner/ Lessee/Contrac as orjDw6er Signature of tractor/License Holder Signature 111 ATE I E OF FLORIDA 15q TE FLORIDA C061[ TY OF MARTIN CO U NTY 0 F MARTIN The 1, 1 6U1 116 instrument was acknowledged before me The forgoing instrument was acknowledged before me this 1,TH day AUGUST 20* by this 13TH day of AUGUST 20A by JUAN ty1ARTINEZ JUAN MARTINEZ of person making statement Name of person making statement PersclName ally Known xxXx OR Produced Identification Personally Known xxx OR Produced Identification Type',. f Identification Type of Identification Produiced Produced (SignAure of Notary Public- State of Florida) (Signature of Notary Public- StateofFlorida Com 1Fission No. GG 197318 (Seal) Commission No. GG 197318 ($WMM. GONZALEZ Ge `Z Florida Notary Public - State of Florida SAMIRA V.. GONZALEZ _o. P94, ,]iorld IS Comrnission 0 GG 197318 Notary Public - State of Flo r da 120 My Comm. Expires Mar 18,2022 ion 4 GG 1973: Connnnissi 8 J� Bonded througi National Notary Alin, 'y REVIEWS FRONT Z Mf my C IV, 1 2.0 2 N ;S/ E GETATION 01 MK 'M It iltrs MA" MR` O-V C COUNTER 1,17 d'd t t i'm REVIEW REVIEW REVIEW DATE I RECU,'� ED DATE 1'1 COLETED Rev. 8/2'17 I