HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9'51 %C'\ SCANNE®Permit Number:
BY Eion
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St. Lucie County
- Building Permit Applica9
Planning and DevelopmentServices riillcpng
Building and Code Regulation Division ---
2300 Virginia Avenue, Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT TYPE: Residential Re -Roof
PROPOSED IMPROVEMENT LOCATION:
12811 NW Cinnamon
Property Tax ID #: 442560200170007
Site Plan Name: Cinnamon Village Harbour Ridge - Plat 3 - Unit 5
Project Name: P•iarse-Reef
DETAILED DESCRIPTION 'OF WORK: 3m S
Remove existing concrete file roofing and replace with same per NOA.
CONSTRUCTION INFORMATION:
Lot No.
Block No.
?6 i* f 5e4 / f,- ,' /2o!!R/—
Additional work to be performed under this permit —check all that apply:
Mechanical
_ Electric
_ Gas Tank
_ Plumbing
_ Gas Piping
_ Sprinklers
—Shutters
—Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 27.000 Utilities: —Sewer _Septic
_Windows/Doors
Roof S/�� pitch
Building Height:
OWNER/LESSEE: Q
CONTRACrOR:
Namewgi $yd4r o to r ZA- J 0
Name: Forrest Riley Smith
Address: Z rid ee OA aAf- a j W a
Company. A Preferred Roofing
City: Y PA �N 8 1— Stater •
Zip Coder 0 q % D Fa/ x:
Phone No.
Address:1696 SW Cimarron Ct
City: Palm City State: FL
Zip Code: 34990 Fax: 772-398-8534
Phone No 772-320-9037
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail smithforrest@belisouth.net
State or County License CCC1328294
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
If value of HVAC is $7500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City: State: _
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:sameasowner
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 permlt 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 concurrenry 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 IN ECTION. IF YOU INTEND TO OBTAINFINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE CORDING YOUR NOTICE OF CONM ENT:'
Signature of Own ssee/font actor as Aged for Owner
Signature of Con rac or/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF !&�'Ic
COUNTYOF ' fL'ld�
The forgoing instrument was acknowledged before me
The forggIng instrume as acknowledged before me
this �day of Ma.� .2011 by
this 2' day of sle 20LL by
Name of person making statement.
Name of person making statement.
Personally Knowri OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
F,_
Type of Identificati n
Produced �f
Produced I.A.
r
4W`'W%' J. SLOAN HOWARD
•'`.
�S'P Notary Public •State of Florida
(SignatureIfI4 S T 1 -. I �d� )
(Signature of Nozs,xon:,.
ommiss;Dn 1 O��b&l
- Expires,��Banded
'°�- through National Not Assn.
Commissio y ra.°„
e.-,�,.. ... �,���8d,�! lgty
Commission No.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.