HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: J 1 ``A Permit Nw
Building Permit Appli
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
APR 17 ?J19
L _ 1,.�.0 County,�ln9
@[�Q SCANNED
BY
St. Lucie Cour
Residential xx
PERMIT TYPE: ROOF—
RR�??OSEbN#?tOVEMENT LOCAOiV,
_
Address: 1624 NW Buttonbush CirPalm City, FL 34990
Property Tax ID #: 4426-840-0005-000-5
Site Plan Name: HARBOUR RIDGE -PLAT 19- TALLOWOODVILLAGE LOT 4 (OR 925-1339: 1084-2968)
Project Name: Owen Residence
Re -Roof ( Tear Off, Install underlayment , Install accesory metals and tile.
Lot No.
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters .�ndows/Doors
_ Electric , _ Plumbing _ Sprinklers _ Generator _`� Roof �_ Pitch
— v _.
LSa._Ft o Conf" struction. �'Z-U -- .. o 'cst.Eoor'"„—a
Cost of Construction: $ 26,960.00 Utilities: —Sewer _Septic Building Height:
OiNtUE12lLESSEE 4
CQNTF � _
Name/ arq
Lau- owens
Name: Juan MQr7'717'&7,
Addressjt222q NW ott-nonyash GIP.
Company:TQ7'%Q PMf-/na Sycte lS SpecOlAr
City: ealm (,I+-U State: FL
Zip Code: 34c 9 Fax: 77 Z 87L 8033
Phone No. 7 72, 87L 90.30
Address:32V/ SE ./XM71?hw retract
city: Stu ctr4- State: FL
Zip Code: 3 L19797 - Fax: -172- 177. 9033
Phone No T72- 97Z 0030
E-Mail:Sa/111riZ OiOWI17106M%rySf111 %J.4
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail StL/Y!% /'cc �ia t0 fi2y rdOf/nlJ Sy51n! .
State or County License GG C 1330799
IT value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTALCONSTRUCTIONssWENIAW
P
INFORMATION
,
— •: r<
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 Court 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 JO"1TE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LEND R AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature Owner/Lessee/Contractor ent rOwner
Signatur Contractor/License
ST OF FLORIDA
ATE OF FLORID
NTY OF Mahn
COUNTY OFManln
The fo 00. instrument was acknowledged before me
The forg''7 g instrument was acknowledged before me
this dayof�jlJ/h20by
this �(, dayof20/9 by
) an �C'V/ 7-
�tAr�t-rZ
Name of person making statement.
��urn
Name of person making statement.
Personally Known ✓ OR Produced Identification
Personally Known L— OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signat
Si natur of. o Pu a
( g s ry k4 g N
<+RY o�`•. SA�MIRA �41.GONZALEZ
Commi IQ�t .eNotary Puhlic-SlaG of j
_?',1'; Notary Public- State of Florida
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COmmI551R �7.= Commission. GG 197314Se
97318i(6e
9" i" ntm fission 3i,G 797318
���S....11 .' My Comm. Expires Mar 18, 2022
;To -n6; Fey omm. xpues Mar 18, 2022
"' Bonded through National Notary Assn.
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