HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO UST E COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: 1 I rl SCANNED Permit Number: (
BY
St. Lucie Countv
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
Commercial X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
Address: Building 16 Sparkling Pines Circle, Fort Pierce, FL 4912+4913
Legal Description: Twn/Sec/Rng 18/34SI40E
Property Tax ID
Site Plan Name:
Project Name: Heathervuay
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
ONO.
-
Block No.
Remove existing 3 Tab shingles. Re -nail wood deck. Dry roof in with self -adhered underlaymen
Install OWENS Corning Supreme Shingles.
FL 16048-R4 Tri-Built Sand-R SA 3//� (� ��
FL10674-R12 Owens Corning Supreme Shingles ,
L�Gas Tank Lf6asPiping
Plumbing ❑Sprinklers
Total Sq. Ft of Construction: _ 1,61 A
Cost of Construction: $ $6 671.55
Shutters ❑Windows/Doors
Generator Q Roof
S Ft. of First Floor: _
Utilities:ll 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: Horgham 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: heatherwavlaura anaol.com
Fill in fee simple Title Holder on next page (if different
from the owner listed above)
E-Mail: tra1993@gmail.com
State or County License: CC C056933 .
ii vaiue of construction Is Sz5uu or more, a RECORDED Notice of Commencement Is required.
AUG-18-2017 13:26 From: To:772462157e Paee:2/2
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DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: Stater
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: ,.,_,_Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lude Counemitmakes no representation that Is granting a ppeermit will authorize the emit holder to build the subject structure
which is in ict any applicable Home Owners As= ation rules, bylaws or anScovenants that may restrict or such
conflty
with prohibit
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 fallure 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
commencin work or rec rdin our Notice of Commencement.
Signatute6f0 ner/ esye /C ntrador as Agent forowner
Signature of Con a tic se Holder
STATE OF FLORIDA
STATE OF FLOR
COUNTY OF St. Lucie
COUNTYOF St. Lucie
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this _ day of .2017by
this _ day of .2017by
Christopher A. Long
Christopher A. Long
(Name of person acknowledging)
(Name of person acknowledging)
-T W-&Z .
-rCa,rt 'AL G/. �i.76Fs
(Signature Af Notary Public- State of Florida)
(Signature off otary Public -State of Florida)
Personalty KnownOR Produced Identification
Personally Known X OR Produced identification
Type of Identification
Type of Identification
Produced
71IAOTHY W. SIJTTON
Produced TIMOTHYW.SUIT
Commission No. 0FSFBUc
A of FLORIr,A
Commission No. FF 10451 PUBLIC
�OF FLORIOA
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE-
RECEIVED
L
DATE
COMPLETED
ev.