HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r (%� /�
Date: 1:n `ao- 1 9 Permit Number:
- Building Permit Application SCANNED
Planning and Development Services St Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential V
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 17280 Hammock Lane Port Saint Lucie Florida 34987
Legal Description: HIDDEN ACRES ELK A LOT 6 (2.77 AC) (OR 3683-1528)
Property Tax ID #: 3211-811-0006-000-9 Lot No.
Site Plan Name: Block No.
Project Name: 17280 Hammock Lane Port Saint Lucie Florida 34987
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace existing roof with new 5-v Metal roof 5V Meth l . 1701Z2. 1
Cyl bGd-a ch c6- Gcim
'ge U L Z 5
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CONSTRUCTION INFORMATION:
Additional work to je nertormed under this permit —check a apply:
❑HVAC LJ Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
❑ Electric ❑ Plumbing ❑Sprinklers ❑ Generator Roof 10/12 Roof pitch
Total Sq. Ft of Construction:`Qe@7 /GULF S Ft. of First Floor:
Cost of Construction: $ 3260(A_Ary(� C� UtilitiesSewer ❑ Septic Building Height:
OWNER/LESSEE: Lisa Stolzenberg
CONTRACTOR: PDKRoofing.inc
Name Lisa Stolzenberg
Name: Dee Keihn
Address: 17280 Hammock Lane
Company: PDKRoofing.inc
City. Port Saint Lucie State: FL
Address: 1299 Sw Biltmore Street
Zip Code: 34987 Fax:
City: Port Saint Lucie State: FL
Phone No. 954-254-8525
Zip Code: 34987 Fax:
E-Mail:
Phone No. 772-528-0113
E-Mail: Pdkroofing.inc@gmaii.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: CCC1331408
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requires.
SUPPLE -MENTAL C NSTRUCTION
LCEN: LAW�INFO,RM
-kTION:
DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:.
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:,
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 ermit 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.
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 ! tend. to- obtain financing, consult with lender or an a orney before,
co work or recur-dMg vr Notice of CommencerryeM.
Signature'of Owner% Lessee/ ontrac—teas Agent for Owner Sign-aru—re of Compactor/Licens Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY; OF COUNTY OF
The r oing instr iyas acknowledg efore me The oing instru n w acknowledgMy
fore me
this day of 20 by thi day of 20
Name of perso aking statement' Name of person aking statement
Personally Known OR Produced Identification Personally KnownOR Produced Identification
Type of Identification : Type of Identification
Produced) Produced
Si natur of Public- ��"`ra��i KAREN S. NIELSE
(Signs ure of ota ublic- State o FI rids. ( g Notary
oot ��•�
KAREN(fink,
�JIELSEN. __ �,St�tie fflorida-Notary P
Commission No. ��` °�a'% a Commission No. •= kssifFr �s
e of Flon a- otary Public y �� C i sion # GG 207�
_• *= Commission # GG 207484 +Commission'OFF, I My Commission Expin
June 12, 2022 My Commission Expires
REVIEWS FRONT ZONING SUPERVISOR PLANS. VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECEI\
DATE
COMP
Rev. 8/2.