HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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� N t l R Permit Number:�tt
r �� RECEIVED
Building Permit Application DEC 4:T2018
Planning and Development Services
ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 .. -.
Phone: (772) 462-1553 Fax: (772) 46u2-1578 Commercial Residee$ntial X .:.
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line "" 1111"wov III
PROPOSED IMPROVEMENT LOCATION: 5t. Lucie Coulip
Address:
Legal Description: RIVER PARK -UNIT
C BLK 74 LOT 11 (MAP 34/28N) (OR 3795-2962; 386649
Property Tax ID #: 3419-570-0024-000-1 Lot No.11
Site Plan Name: Block No. 74
Project Name:
Setbacks Front Back: Right Side: Left Side:
I, DETAILED DESCRIPTION OF WORK: III
Re -roof. Remove existing shingle roof and replace with 1" Standing Seam Snapback Metal Roofing
System.olygfQ� 17Y�$V�j((m�jlti�
I CONSTRUCTION INFORMATION: III
❑H\ A - Gas Tank Gas Piping _ Shutters Q Windows/Doors
11 Electric 0 Plumbing HSprinklers 0 Generator Roof "'TTTRoof pitch
Total Sq. Ft of Construction: �r Sof First Floor:
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Cost of Construction: $ 15,000.00 Utilities. -I] Sewero Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name errs Walden
Name: scar O ara
Address: 119 NE bracken Rd.
Company: Elite Rooting Solutions,
Inc.
Port t.ucie
City: State: _
LincolnAve.
Address: 8
City: Stuart
FIL
State:
Zip Code: Fax:
34994 772�266-82W
Phone No.
Zip Code: -Fax:
Phone No. 772-643-7663
E-Mail:TerrlWa en Otmal 1.com
Fill in fee simple Title Holder on next page (if different
E-Mail: Off lCe.e iteroO ingsO utlons
gmal .com
from the Owner listed above)
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State: _
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City: rn
(: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.
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
commencing work or recording your Notice of Commencement.
Sign re ofOwna/Contractor as Agent for Owner
SiWatiureW or/License Holder
STATE OF FLORI
STATE OF F O�RI �J � /—
COUNTY OF furl.
COUNTY OF Y 0 I (4J)�lC/1C.
The fo ing fnst nt was ack owledged before me
d 2018 by
The forgoing ins tw ent was ackn�owledged before me
I�'
this day of 20/8by
this of
ry7
Name of person making statement
Name of p rson making statement
Personally Known OR Produced Identification
Personally Known ,W OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
P�Ie_x�o
Eka9&r6 C�
lc__
(Signature of Not i ft muf`Ftatl841p
(Signature of I � U rlEa
,ISO, STATE OF FLORIDA
Commission No. omm#GG1 fb
gQ a STATE OF FLOR(.QA
FLO eal)
Commission "
,:±
�fc�C I Expires 7/19/2021
y o G
sNce te�0 Expires 711 M021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17