HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: ROOF
PROPOSEQyIMP.,Rb'M NT LOCATION
Address: 3251 (liver DrFort Pierce, FL 34981
Property Tax ID #: 2430-502-0019-000-4
Site Plan Name: Thomas Residence
Project Name:
DETAILED DESCRIPTION OF WORK:' }
Permit Number: I 1 O t -1 1 V
SCANNED =Luden
BY
St. Lucie County.
Building Permit Applicati
Commercial Residential ✓
Tear Off, Install Peel and Stick, Accesory metals and metal
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: � Sq. Ft. of First Floor: _
Cost of Construction: $ 11.000.00 Utilities: —Sewer _Septic
Lot No.19
Block No.
Windows/Doors
:! R- oof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR
Name / o✓>,GS
Name:JuanMartinez
Address: Sj IZ i VPJ' b 12
Company:Total Roofing Systems Specialist
City: -o ✓f- 77 t Ge— State: -L
Zip Code: 3 Lt t1f) Fax: -7 7 2 -S 7 2- J a s >
Phone N0.7728728030
Address:3201 SE Dominica Terrace
City: Stuart State: FL
Zip Code: 34997 Fax:
Phone N07728728030
E-Mail:Samira@totalroofingsystems.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Samira@totalroofingsystems.net
State or County License C C C. 133'I ON-J'
11 vnioe v! wnxroawn isprow or more, a ntwnutu ivotice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL
CONSTRUCTION<LIEN LQN/ INFORMATIGN
�.
`
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 contlict 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 9V THE JOB SITE BEFORE THE FIRST INSPECTION. IF YO INTEND TO OBTAIN FIyANCING, CONSULT
WITH YQLjt LENDER OR AN ANTORNEY BEFORE RECORDING YOUR�TICE OF COMMENCEMENT--
aignar a or uwner/ Lessee/c ntractor as Agent for Owner Si7UNTY
re of Contractor/License older
STA E OF FLORIDA SOF FLORI4q
COUNTY OF , ✓ �I ^ Si OF I"l i
The forgoing instrument was acknowledged before me The for of g instrurrt s acknowledged before me
this �ay of
M o6Y 20� by this 1 y Of. 204 by
J liq 1� vi/ I/�PZI1? aL�(J ✓1 a:�4Y ;A7 hP�2
Name of person making stat N ma a of person making statement.
e.-
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
,(Sighature of Notary Public -State of Florida) nature of Notary Public- State of Florida )
Commission No. � tCommissionNo_� (Seal)
JPERVISOR I PLANS
REVIEW REVIEW
COMPLETED