HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (J
Date: �1�1 \6\ Permit Number:
SCANNEDEAPR
D
BY
St. Lucie Coun19
Building Permit Applica ioPlanning and Development Services rinittin
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XXXXXXXX
PERMIT APPLICATION FOR: Roof - M--\-gA (w�ol����
PROPOSED IMPROVEMENT LOCATION: V
Address: 471 ANN MARIE CIRCLE PORT ST. LUCIE, FL 34952
Legal Description: LA BUONA VITA COOPERATIVE UNIT/LOT 196 (OR 1432-676)
Property Tax ID #: 3423-664-0190-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REMOVE EXISTING ROOF & REPLACE ANY ROT
INSTALL S/A H.T. UNDERLAYMENT
INSTALL 26 GA METAL ROOF SYSTEM /07 D A n
CONSTRUCTION INFORMATION:
Additional work to e e orme under t—checkispermit a apply:
11HVAC �GasTank �GasPiping _Shutters ❑Windows/Doors
11 Electric El Plumbing Sprinklers ElGenerator Z Roof
Total Sq. Ft of Construction: 1,550 Sq. Ft. of First Floor:
Cost of Construction: $ 6,975 Utilities: Sewer OSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name LESLIE LADOUCEUR
Name: JOE BAKER
Address:471 ANN MARIE CIRCLE
Company: BIG LAKE ROOFING & REPAIRS
City: PORT ST. LUCIE State: FL
Zip Code: 34952 Fax:
Phone No.772-878-6160
Address: 2699 NW 16TH BLVD.
City: OKEECHOBEE State: FL
Zip Code: 34972 Fax: 863-763-7662
Phone No. 863-763-7663
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: BIGLAKEROOFING@YAHOO.COM
State or County License: CCC046939
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: of Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: of Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 vour Notice of Commencement.
Signature f Owner/ Agent/ lessee Signature f Co tractor Licen Holder
older
STATE OF FLOI� COUNTY OFSTATE OF O , l�el A_2dafe COUNTY FLO
The o oing instrum nt was acknowledge efore me
this ayof 20 by
(Name of person acknowledging)
s� (Signature of Notary Public -St a of Florida )
Personally Known _ X OR Produced Identification
Type of Identification Produced
Commission No.
Revised
The Ing instruTent waslacknowledged before me
fo.r
this day of - p` l . 20by
�a� e�
(Name of person acknowledging)
iS gnature of Notary Public( of Notary Public-Stat�Florid�
Personally Known OR Produced Identification
Type of Identificatio—,n( Produced
NIYCOMMI SON#GEDWARDSONG 2115185 I Commission
RE)MER EDWARDSON
MY COMMISSION # GG 215185
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