HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 19lo-oll/I
SCANNED
RECEIVED
By
Building Permit Application et Lurie COMWO 92010
Pla i ning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Roof
I'PROPOSED IMPROVEMENT LOCATION: J
Add
: 9433 Meadowood Dr.
Legal Description: Monte Carlo County Club Unit One - Lot 285
Property Tax ID #: 1327-801-0091-000-0
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No. 285
Block No.
Tile tear off, renail plywood, apply 30# felt and TU Max self adhering underlayment. Install Boral
Plantation flat the with two galvanized screws per tile. F1Q.;E- IRQo-kc —14PPft/ A lavefS O-C—
S A V ay. a oVk_Q_ I uAdV' S'g Pa
onal worK to bje nerrormed unoer tnis permit— cnecK all apply:
HVAC L _J Gas Tank Gas Piping M_ Shutters
Electric Plumbing 11 Sprinklers FIGenerator
Tota[Sq. Ft of Construction: 5400
Cost of Construction: $ 41,000.00
S�Ft.I of First Floor: _
Utilities. — Sewer FISeptic
Windows/Doors
Roof Roof pitch
Building Height: 1 & 2
OWNER/LESSEE:
CONTRACTOR:
Name Bruce Newbold
Name: David Packard
Address:9433 Meadowood Dr.
Company: Packard Roofing & Waterproofing, Inca
City: IPort St. Lucie State:FL
Address: 2182 NW Reserve Park Trace
Zip Code: 34951 Fax:
City: Port St. Lucie State: FL
Phone No.
Zip Code: 34986 Fax: 772-468-9978
E-Mail:
Phone No. 772-468-3723
Fill in'ifee simple Title Holder on next page (if different
E-Mail: ssmith@packardroofing.com
from;the Owner listed above)
State or County License: CCCA17517
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: ✓Not Applicable
Name:
Name:
Add ress:9433 MeedoWood Dr.
Address:
City: State:
City: State:
Zip- Phone
Zip: Phone:
OK
FEE SIMPLE TITLE HOLDER: V Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Add ress:
Address:
City:
City:
Zip: Phone:
Zip:, Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify 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 consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
i
The following 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
improvements 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 attorney before
rnmmPnrinp wnrk nr rernrrlinp vour Notice of Commencement.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF f & i.e
COUNTY OF
The fo ing instrument was acknowledged before me
The for Ding instrument was acknowledged before me
this ���day of CtJrAgQZ 201 Cby
thi�day of Qr, - , 20ff by
1%GLN I at c)
Ind &44 C„&Z
Name of person;naking statement
Name of person king statement
✓ maOR
Personally Known ✓ OR Produced Identification
Personally Known Produced Identification
Type, of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev. 8/2/17