HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST) BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater � % • % 9 SCANNED Permit Nw
BY
St. Lucie County
Building Permit Appl
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
PERMIT TYPE: Re -Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 6200 Johnston Road
Property Tax ID #: 1303-323-0001-010-5
Site Plan Name:
Project Name:
Resid
DETAILED DESCRIPTION OF WORK: I '
Remove existing shingle roof Replace wl new SS metal roof
Remove existing 2 skylights Replace wl 2 new skylights
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mor- D 0'1'�
Lot No.
Block No.
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof fO /S;2 Pitch
Total Sq. Ft of Construction: 1836
Cost of Construction: $ 29282.69
Sq. Ft. of First Floor: 1836
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Daniel Brolmann
Name: Danielle Ryckman
Address:6200 Johnston Road
Company:Agliance Group
City: Fort Pierce State: _
Zip Code: M951 Fax:
Phone No.
Address:615 NW Enterprise Drive
City: Port St. Lucie State: FL
Zip Code: 34986 Fax: 772-492-8008
Phone N0772-492-8006
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail hether@alliancegroupllc.com
State or County License CCC1 330918
If value of construction is $2500 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
e
DESIGNER/ENGINEER: x Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone -
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Sign ture of Contractor/Licens older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF St.wde
COUNTY OF sl. Lude
The forgoing instrument was acknowledge before me
The forgoing instrument was acknowledged_before me
this 23m day of April 2014 by
this 23r4 day of Apol
, 20-4 by
DanieAe Rydnnan
Danielle Ryc n
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x
OR Produced Identification
Type of Identification
Type of Identification
Produced
Pro ced
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(Signaturkjof Notary P
(Signature of tary Pu '
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Notary Public Stale of Florida
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Commission No. GG224 VJ1%BlanG
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Commission No. GG224soa
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Expiree 0610312022
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�a�' Expires 0810312022
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