HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t I
Date: SCANNED Permit Number: Y�04i - 63k/
ram: ll �:_,�- , BY
o - St. Lucie Crnmhv RECEIVED
Building Permit Application MAY 16 20V
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 04 Sparkling Pines Circle, Fort Pierce FL 49924994+4990
Legal Description: Twn/Sec/Rng 18/34S/40E
Property Tax ID q: 1418-231-0001-000-3 Lot No.
Site Plan Name:
Project Name: Heathe a'ay
Block No.
Setbacks Front Back: Right Side: Left Side:
"DETAILED DESCRIPTION OF WORK:
Remove existing 3 Tab shingles. Re -nail wood deck. Dry roof in with self -adhered underlaymen
Install OWENS Corning Supreme Shingles. - ] I in�
CONSTRUCTION INFORMATION:
I� Gas Tank
❑Gas Piping
U Shutters
❑
Windows/Doors
0
Plumbing
❑Sprinklers
[]Generator
0
Roof
Total Sq. Ft of Construction: _2,381 S Ft. of First Floor:
Cost of Construction: $ G1RQ2 6n Utilities:] Sewer OSeptic Building Height:
OWNER/LESSEE:!
CONTRACTOR:
Name Heatherway Ft. Pierce, Ltd.
Name: Christopher A. Long
Address: 200 Witmer Road
Company: The Roof Authority, Inc.
City: Hnrchnm State: _M
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.1772) 468.7870
E-Mail: heatherwavlaura(Daol.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: tral993@gmail.com
State or County License: CC C056933
11 value ai construction is 4-2500 or more, a Rmumutu Notice of Commencement is required.
J
LIEN LAW,
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
Zip: Phone:
I certify that no work or installation has commenced prior to the Issuance of a permit.
St. Lucie Counttyy 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 record)ne vour Notice of Commencement.
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTYOF S-F Lain
The for�QIng instru�rt/dent was acknowledged before me
this�dayof ! 1 N 20 1by
]aL`-Y& AAA uvs
(Name of person acknowledging IOvmer/LesseefAg_�nt Printed Name
(Signature of Notary Public -State of Florida )
Personally KnTIMOTHY W. BUTTON
own G9Yfi11ARtFf{�j��
Type of Identification Pro OF R AR -A -
FF104511
Commission No. ^F 0 // E i 3/20l2018
Revised 07/15/2014
OF I-1— a
The forgoing instrunjent was acknowledged before me
this _Li ay of IE4 20 ) by
c^r s n Yes
(Name of p rson acknowledging) Contractors Name
Trrnn.fL 1, k5A"T
(Signature 6f Notary Public- State of Florida )
Personally Known `� 0 I ce1iIIQXt fAi�TON
Type of Identification Prod NOTARY PUBLIC
STATE OF FLORIDA
Commission No. CQWjW104511
Expires 3/20/2018
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