HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �7 J 01� l
Date: May 1, 2019 Permit Number: �/ d� V V 1
RECEIVED SCANNED
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Building Permit Application MAY 08 20%t.LucB County
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax:.(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
I PROPOSED IMPROVEMENT LOCATION: III
Address: 4114 Poinsetta Avenue, Fort Pierce, FL 34982
Legal Description: 33 35 40 FROM SW COR OF E 1/2 OF NE 1/4 OF SE IM RUN N 190 FT FOR POB, TH E 105.97 FT, TH N 31 FT, TH W 5.97 FT
TH N 31 FT, TH W 5.97 FT, TH N 89 FT, TH W 100 FT, TH S 120 FT TO POB (0.28 AC) (OR 3147-2373)
Property Tax ID #: 2433-414-0003-100-9 Lot No.
Site Plan Name:
Project Name: Osipchuk
Setbacks Front Back: Right Side:
DETAILED DESCRIPTION OF WORK:
Remove and replace existing roof covering -
Extreme Metal: 5V FL20378-RI
Titanium PSU 30 : FL11602-R7
Left Side:
Block No.
CONSTRUCTION INFORMATION: II
Additional workto e e orme under t—checkispermit a apply: �I
�jHVAC LJ Gas Tank ❑Gas Piping _Shutters E] Windows/Doors ,
11 Electric Plumbing Sprinklers 11 Generator R1 Roof 5/12 Roof pitch
Total Sq. Ft of Construction: 2.956 ScFt. of First Floor: 3,000
Cost of Construction: $ 16,300.00 Utilities:Sewer OSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameAleksandr O & Mandy A Osipchuk
Name: Layy Neese
Address: 4114 Pionetta Avenue
Company: LARRY NEESE, LLC
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No.772-626-9247
Address: 3401 S. US Highway 1
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-361-6580
E-mail: mandysellsflorida@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-mail: Iarryneeserooflng@gmall.com
State or County License: CCC1330608
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: xx Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Address:
City:
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 hrestrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions wich 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 us
WARNING TO OW r failure t ecord a Notice of Commencement t in your payin us
for
improver o your pr a. otice of Commencement mus a recorded nd pas n the jobsite
before the rst in . If intend to obtain financing, coLilt with lend or ttorney before
commen Ina wor record' vour Notice of Commencement
Signatu of Owner/ Lesse tractor as Agent for Owner
Signature of ntrac r/ ense der
ST E OF FL A
STAT F FLORIDA
C N St. Lucie
COU Line
The forgoing instrument was acknowledged before me
The orgoing instrument was acknowledged before me
this IMdayof ry)ai 2oA by
this day ofMbg 20& by
Larry C Neese
Larry C Neese
Name of per on making statement
�
Name of per on making statement
Personally Known OR Produced Identification
Personally Known I� OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Lary Publi - S a e o F o i a
(Signature of ry Pu'
q 5tero of Fbraa
Notary Pudic Siato of Fion"
7 � Amy 1
Commission No. l.l�-� {�k
FVllj� IV WOOd
Commission No. ' $�
My Co mes—i6n GG 241645
My Comtrxuitm GG 241845
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Aat,pF Expires 07/25/2022
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Rev.8/2/17