HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr
S, x..nnctS -
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/17/17 Permit Number:
Building Permit Application SCANNED
Planning and Development Services BY
Building and Code Regulation Division St. LUr;ip rnlintir
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Roof H
ENT
Address:
Legal Description:
Property Tax ID #: LA509 ' p c - (gym-- oub' `Y Lot No.
Site Plan Name: Block No.
Project Name: �QFl(1015 PY252YVe SiU t Wlk
Setbacks Front Back: Right Side: Left Side:
I DETAILED DESCRIPTION OF WORK: III
Re -roof. (` � ��r • /� /�
I//aJ(II//a
I CONSTRUCTION INFORMATION: III
LIHVAC I _I Gas Tank UGas Piping
a
❑Electric ❑Plumbing ❑Sprinklers
IITotal Sq. Ft of Construction:/ S�l
Cost of Construction: $
a
Shutters ❑ Windows/Doors
Generator N Roof ❑ Roof pitch
SqI FFtt.� of First Floor: _
Utilities: Sewer ❑ Septic
Building Height: 9 2-
OWNER/LESSEE:
CONTRACTOR:
Name W -�- .
Name: Dave Wikel
Address: ) lV
Company: Therma Seal Roof Systems, LLC
City: -TaWokwSee State: f_-
Zip Code:3a�-tI Fax:
Phone No.._ _Sro/ -% 3 - Zy q
Address: 1421 Oglethorpe Rd
City: West Palm Beach State:FL
Zip Code: 33405 - - Fax: 561-444-2272
Phone No. 561-223-2096
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: irivera@thermasealroofs.com
State or County License: CCC1325862
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: III
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
x Not Applicable
BONDING COMPANY: x Not Applicable
Name:
Address:
City:
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
WARNING10 OWNER: Your 'lure to Record a Notice of Commencement may result in your paying twice for
impro me is to your e . A Notice of Commencement must be recorded an posted on the jobsite
befor the first inspe I If ou intend to obtain financing, cons ith lenden a orney before
co err work r ord" a vour Notice of Commencemen .
STATE OF FL
COUNTY OF
Thefo,[go�inginstrurgen�twa{acknowledged eforeme
this _ _yhy of L 1p 20 y
1\12 w �L
(Name of person acknowledging )
g ure of Notary Public- State of Florida )
Personally Known
Type of Identifical
Commission No.
STATE OF FLORIDA L��
COUNTY OF M QA 1 1 r�)2xcN
V
The fojjr iYin��g instrumeen������t''''''�w��_a""""""��1��1
sacknowledged before me
this ITQyof�///20_ftby
"_
� Commission M GG 1146117
My(IiT Omission Expires
January 22. 2021 11
Dave Wikel
(Name of person acknowledging)
Ky
(Sig ture of Notary Public- State of Florida )
of
Known x
f, ' Commission It GG
No. 1" j -1 My (` Vijission r
"i—WV January ;42. -
0"4 JASMINE RIVERA 19
--Revised 07/15/2014 A �� —Commission 0 GG 64667
•r My Commission Expires
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
nunmaJanuary
VE
REVIEW
REVIEW
btA ITMTCr4iff0OV`E
REVIEW
DATE
COMPLETE
INITIALS