HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONqqq(� --4 �
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I ✓1 n 4
Date: SCANNED Permit Number: 1 `0s -os t�
BY RECEIVE®
St. Lucie Count/
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
MAY 2 6 2017
PERMITTING
St. Lucie County, FL
Commercial X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line II
address: Building 03 Sparkling Pines Circle, Fort Pierce, FL
Legal Description: Twn/Sec/Rng 18/34S/40E
Property Tax ID #: 1418-231-0001-000-3 Lot No.
Site Plan Name:
Project Name: Heafhenivay
Setbacks Front Back: Right Side: Left Side:
'DETAILED DESCRIPTION OF WORK:
Block No.
Remove existing 3 Tab shingles. Re -nail wood deck. Dry roof in with self -adhered underlaymen
Install OWENS Corning Supreme Shingles.
FL 10450-R8 TARCO ROOFING LeakElarrier MS 300
FL10674-R12 Owens Cornina Supreme Shinales
1,CONSTRUCTION INFORMATION: -11
UIIUC, l,p. JJCI l 1111-u
Gas Tank ❑Gas Piping
0 Plumbing ❑Sprinklers
Shutters ❑ Windows/Doors
Generator EjRoof
Total Sq. Ft of Construction: 2 381 S Ft. of First Floor: _
Cost of Construction: $ J 695.20 Utilities:T]Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Heatherway Ft. Pierce, Ltd.
Name: Christopher A. Long
Address: 200 Witmer Road
Company: The Roof Authority, Inc.
City: _ Hnrcham State: RA
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. (772)468.7870
E-Mail: heath erwavlaura(cDao1.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
If value of construction Is $2500 or more, a RECORDED Notice of Commencement Is required.
MENTAL CONSTRUCTION LIEN LAW IN
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MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City:
State;
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
_ Not Applicable
BONDING COMPANY: 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
befor the first inspection. If you intend to obtain financing, consult with lender or an attorney before
comlNencing work or recording your Notice of Commencement.
STATE OF FLORIDA I STATE OF FL
COUNTY OF St. Lucie COUNTY OF
The for ng rostrum nt was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 [Zby this�day of I 20 f by
Christopher A. Long
(Name of person acknowledging) O..riLessee/Agent Printed Name (Name of person acknowledging) Contractor's Name
T��, W S taw
(Signature of N Lary Public- State of Florida) (Signature of Notary Public- State of Florida )
Personally Known .� dulb�itiijc3�r Of'h( Personally Known X OR Prop .ntTijilTi W. SUTTO
Type of Identification Pra Tr Y�}L8�=1�� Type of Identification Produced i P NOTARY
Commission No. FF 10 = Can��104511 Commission No. FF 104511 a FF104511
t Expires 3f202018 t> Expires 3120/2018
Revised 07/15/2014
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SUPERVISOR
PLANS
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DATE
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INITIALS
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