HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n
Date: �� 19 ' it SCANNED Permit Number: J7yS— aw
St. Lucie Cot RECI$'HI
Building Permit Application MAY 16 2017
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 X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line ,II
Address: Building 05 Sparkling Pines Circle Fort Pierce FL 4986 4988+4984
Legal Description: Twn/Sec/Rng 18/34S/40E
Property Tax ID #: 1418-231-0001-000-3 Lot No.
Site Plan Name:
Project Name: HeatbervitaIg
Setbacks Front Back: Right Side: Left Side:
N OF WORK:
Remove existing 3 Tab shingles. Re -nail we
Install OWENS Corning Supreme Shingles.
CONSTRUCTION' INFORMATION:
❑HVAC IJ Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction:. 2,112
Cost of Construction: $ 8,751.31
Gas Piping
Sprinklers
Block No.
apply:
Shutters ❑ Windows/Doors
Generator 0 Roof
S Ft. of First Floor: _
utilities Sewer Septic
Building Height:
OWN ERAESSEE ,
CONTRACTOR:
Name Heatherway Ft. Pierce, Ltd.
Name: Christopher A. Long
Address: 200 Witmer Road
Company: The Roof Authority, Inc.
City: Hnrchnm State: -PA
Zip Code:19044 Fax:
Phone No. 772-468-2333
Address: 6771 North Old Dixie Highway
City: Fort Pierce State: FL
Zip Code: 34946 Fax: (772)468-2247
Phone No. 468.7870
E-Mail: heatherwavlaurata'�.aol.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
_(772)
E-Mail: tral993@gmail.com
State or County License: CC C056933
.o1b ��UW vF more, a ncwnueu nonce or commencement is required.
LAW
UE5I0NER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
MORTGAGE COMPANY:
Name:
Address'
City:
Zip: Phone:
BONDING COMPANY:
Not Applicable
_Not Applicable
Name'
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commenrement
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St. Lucie COUNTYOF St. Lucie
The forgoing instrument was acknowledged before me The forgoing instrur�l}ent was acknowledged before me
this a day of � 20 LZby this_Lodayof /T— 20 LZ_ by
i sV.rh All tPgi)S I OLa IS'n2 f) r� /L LrIv\A
(Name of person acknowledging )Owner/Lesseeingent Printed Name (Name of pers n acknowledgin Contractor's Name
(Signature of Ndtary Public- State of Florida )
Personally Known OR Produ ed Identification ✓
Type of Identification Prod��rIMOTHY W. Smo
Y PUBLIC
Commission No. �STATA¢ily FLORIDA
COMW FF104511
e.,..,—_ __ . _
Revised 07/15/2014
T,r,-rrNI-RM Wswtt-,�
(Signature of Ndtary Public -State ,fIF�TFdaa SUTTOH
Personally Known �eR'
Type of Identification P STATE OF FL �R
Commission No. f` Expireq�Q/2018
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