HomeMy WebLinkAboutBUILDING PERMIT APPLICATION1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED
C N ED Permit Number: - Q
St. Lucie County is
Building Permit Application JUL I v 2017
Planning and Development Services PERFAITTINC,
Building and Code Regulation Division St. Lucie County, F.
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax:(7721462-1578 Commercial X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
Address: _Building 19 Sparkling Pines Circle, Fort Pierce, FL Units 4911 4917 4913 4915
Legal Description: Twn/Sec/Rng 18/34S/40E
Property Tax ID #: 1418-231-0001-000-3 Lot No.
Site Plan Name:
Project Name: Heatherway
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.
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CONSTRUCTION INFORMATION:
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HVAC Gas Tank ❑Gas
perms—GneGK all apply:
Piping Shutters ❑
_
Windows/Doors
Electric 0 Plumbing
Sprinklers Generator
Roof
Total Sq. Ft of Construction: 1 z;97 5 Ft. of First Floor:
Cost of Construction: $ 14,795.00 Utilities:Sewer D Septic Building Height:
OWNER/L-ESSEE:
CONTRACTOR:
Name Heatherway Ft. Pierce, Ltd.
Name: Christopher A. Long
Address: 200 Witmer Road
Company: The Roof Authority, Inc.
City: Horsham 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. -(772)468.7870
E-Mail: heatherwaVlaura(a)aol.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.
1_SURPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: -III
•.�„,•.,•�w �.�••��.•, _ IMUL` PPucdute MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
BONDING COMPANY:
Name:
Address:
Zip: Phone: II Zip:
certify that no work or installation has commenced prior to the issuance of a permit.
ne:
_Not Applicable
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
commencinR work or recordine vour Notice of Commanrpmpnt
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF St. Lucie
STATE OF FL
COUNTY OF
The foriping instrument was acknowledged before me The for oing instrum nt was acknowledged before me
this iF day of 1) LlT_ 20 �by this.7day of JwT 20 17 by
Laura Buderus I Christopher A. Long
(Name of person acknowledging )OwnenLessee/Agent Printed Name (Name of person acknowledging ) COrltraCtOr'S Name
-rNm Ai,, L,), S v_cr, In
(Signature of N tary Public- State of F*-ExOM
I�HY W SLRToN
Personally KnownjI.g� ;y;,,{�jf� Q O x
Type of Identification Pro�L4d�nn
n�m FFiDiSTf--
Commission No. FF13/20/2018
Revised 07/15/2014
(Signature of Nckary Public- State of Florida I TIMOTHY W. SUTTO
Personally Known X OR Pr fvy& PUBLIC
Ofa
Type of Identification Produced _
Commission No. FF104511 4RMSeeores 3120f2018
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS