HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
-D--— - I-- --- --- - —Permit Number: — - —
. RECEIVED
Building Permit Application JAN 15 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof SCANIN,ED III
Address: 10656 Pine Cone Lane, Fort Pierce, FL 34945
Legal Description: PINE HOLLOW -UNIT ONE- LOT 15 (1.08 AC) (OR 3792-2143)
Property Tax ID #: 2321-801-0015-000-9
Site Plan Name: Jason Williamson
Project Name: Jason Williamson
Setbacks
Flat Re -Roof.
(See attached Proposal.)
Back:
HVAC "Gas Tank
Right Side: Left Side:
AIL—CISUL&d1l dpply:
Piping _ Shutters
11 Electric 0 Plumbing Sprinklers 11 Generator
Total Sq. Ft of Construction: 0� 5 Ft. of First Floor:
oJ
Cost of Construction: $ ��� Utilities: Sewer OSeptic
Lot No. 15
Block No.
Q�Windows/Doors
IL,1.Roof Mu Roof pitch
Building Height:
WNER� CE
RA iORe
Name Jason Williamson
Name: John L Ross
Address:10656 Pine Cone Lane
Company: Hannabri Services, Inc.
City: Fort Pierce State: FL
Zip Code: 34945 Fax:
Phone No.
Address: 2175 20th Street, Suite C
City: Vero Beach State: FL
Zip Code: 32960 Fax: (772) 794-0409
Phone No. (772) 794-0408
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: info@hannabdroofing.com
State or County Ccense: CCC 1327971
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL GONSTRIII Z ION LIEN L V1! INFORN/IATI®N:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
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 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 inspeyytion. If you intend to obtain financing, consult with lender or an attorney before
cuwnenciw work or -recording vour Notice of Commencement.
�Signa ure*ofbwne7/ "epee CbritractorasAgenf:'fofOwne
Signatureo Holder
ST TE OF FLORIDA
UNTY OF
STATE OF FLORIDA
COUNTY
OFJ�� �f
he forgoing instrument was acknowledged before me
1\ MGVeml
The forg instru�mentt was acknowledged before me
NK3.
this dayof zi .20)lby
thisrZD da of 20A$by
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Name of person making statement
Name of person making statement
Personally Known OR Produced Identification X
Personally Known OR Produced Identification
Type of Identification
�1�
Type of Identification
Produced VC L
Produced �Q
(Signature of Notary Public -State of Florida)
(Signature of Notary P I' -
Commission No. s taryPAS%WkofFicrida
yr+.y, Notary Publie State of Flande
Commission No. rF -`t� Melissa I)1
F Sarah E Roycroft
ti r . MY Commission GG 260577q�gP
a My commsslon tiG 253906
Expires Osn412022
EM", 0912012o220.
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Rev.8/2/17