HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI�l
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (�
Date: 5(;HNNED Permit Number:
BY
St. Lucie County
—_ - --- Building Permit Application 0.Ece1vED
Planning and Development Services MAr 0 6 10�9
Build
and Code Regulation Division
23001 Virg nia Avenue,, Fort Pierce FL 34982 permittingtie County nt
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ResidentialXX
PERMIT TYPE: RE -ROOF
PROPOSED IMPROVEMENT LOCATION:
Address: 3312 NW PERIMETER RD
Property Tax ID #: 4436-510-0026-000-5
Site Plan Name:
Project Name: GUBA RESIDENCE
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I
RE -ROOF SHINGLE Ti
PITCH-5/12
3500 SQ. FT
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit — check all that apply:
_Mechanical _GasTarili-,' _ _Gas Piping _Shutters
_ Electric, Plumbing . _Sprinklers
Total Sq. Ft of Construction: 3500
Cost of Construction: $ 25,000
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
_ Roof 5112 Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Philip P Guba _ ...
Name: JOSEPH KOLINOSKI
' 3312,NW Perimeter Rd ,Palm`-Ci
Address: b, F134990
Company: ONSHORE ROOFING SPECIALISTS, INC
City: "' State:_
Zip Code: "Fax:.
Phone No.
Address: 4401,.SE:COMMERCE,AVE`
STUART'% ^ � FL
City: State:_
Zip_ Code:,34996'�t"'' "'Fax: 772-283-1557
PhoneNo772-283-1505
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail INFO@ONSHOREROOFING.COM
State or County License
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 IN,
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:
Name:
_Not 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 IMPROVEMENTS TO YOUR JNWPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB climlit BEFO E FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LEND A RNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. -
Signature o w see/Contractor as Agent for Owner
ig r or/License Holder
STATE OF FLORIDA/q �
STATE OF FLORIDA�,�,
COUNTY OF ('l�L
COUNTY OF / / (/l a
Thefo inginstrum n wasackno gdge fore me
Thef ing ins wasac now edt ore me
this day of 20 -,y
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this day 20 y
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Name of persorinnakRig stdt ent.
Name o perso makingstato ant.
Personally Known OR Produced ification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
signa ary Pu i - Fl�jq�Y)°uhlic Slate or Florid,
(Signatur f No ry Public- to of Flo i a
t nsne Neal Hutchinson
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REVIEWS
FR NT�REVIEW
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTEREVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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