HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: fPermit Number:
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Building Permit Application JgNI4 GC4%
Planning and Development Services penmltti 2019 S BY
2300Build/ng and Code Regulation Vii Virginia Avenue, Fort Pierce FL 34982 vision 3r LpCe c u ty 9ar f. �uC%e Ct
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
Address: 3500 WHITE WAY DAIRY RD FORT PIERCE, FL. 34947
Legal Description: 17 35 40 SW 1/4 OF SE 1/4 OF NW 114-LESS W 30 FT AND LESS S 48 FT
AND LESS E 160 FT OF W 300 FT OF S258 FT- (8.08 AC) (OR 928-969: 4070-1846) (BUILDING #4)
Property Tax ID #: 2417-243-0001-000-0 - (BUILDING #4) Lot No. N/A
Site Plan Name: Block No. N/A
Project Name: Bullock - Re -Roof
Setbacks Front Back: Right Side: Left Side:
Remove and replace existing roof covering
Extreme Metal 5v : 20378.6
Titanium PSU 30 : FL11602-R5
Low Slope: Modified Bitumen: FL1654-R23
HVAC LJ Gas Tank UGas Piping
Electric 0 Plumbing Sprinklers
Total Sq. Ft of Construction:
1500
Cost of Construction: $ 12,100
Shutters Windows/Doors .125/12
Low Slope
Generator 1�1 Roof 4/12 Roof pitch
S Ft. of First Floor: 1500
UtilitiesSewer Septic Building Height:
OWIUER/LESSEE:
,CONTRA
iOR$
Name Bullock Rand E LLC
Name: LARRY NEESE, LLC
Address:3650 Whiteway Dairy RD
Company: LARRY NEESE, LLC
City: Fort Pierce
Zip Code: 34947 Fax:
Phone No.772-359-0559
State:Fl_
Address: 3401 S. US Hwy 1
City: FORT PIERCE State: FL.
Zip Code: 34982 Fax:
Phone No. 772-361-6580
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: Iarryneeseroofing@gmall.com
State or County License: CCC1330608
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPRLEML CONSTRU 310N
EIUTA
LIEN LAWINFORMATION
A,
.
DESIGNER/ENGINEER: _
Name:
Not Applicable
MORTGAGE COMPANY: _
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY: _Not
Name:
Applicable
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 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
improve our property. A Notice of Commenceme ed and posted on the jobsite
before th first i pec ' n. If you intend to obtain financing, consult with len e r an attorney before
commencin c r m tice of Commenceme t.
Igna ure o actor as Agent for Owner
Signature or License Holder
STATE OF FLORIDA
COUNTY OF a. LUCIe.
STATE OF FLORIDA LI ICI
COUNTY OF
The for oing instrument was acknowledged before me
this I day of -mr1 , 20A9 by
The forgoing instrUprit was acknowledge before me
this � � day of J LL,M1 , 20 by
Larry Neerse
Larr1 Neese
Name of erson making statement
Personally Known X—OR Produced Identification
Name of person making statement
Personally Known,_ OR Produced Identification
Type of Identification
Type of Identification
Produced ��U 1^tI�(��
y t/�`,, n. V V \Yxw`
(Signature of klitary Public- State of Florida)
Commission No.C•'1C1XI „J ea otery Puhlio Stets of F
Amy N Wood
My commission GG 24
0 025/2022
Produced �/��/�
wy In. v Vwo
(Signature of La/r Public- State of Florida )
m sion No. l� 0:
Noto u i 'State of Florioe
Amy N Wood 4
645 My Comosssion GG 241e45 f
REVIEWS
FRONT
PLANS
VEGETATIO
L
A RO
I
SUPERVISOR
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17