HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONA.
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _ SCABNrNED Permit Number:
s Q-3; - w _ - St. Lucie County RECEIVED
Building Permit Applicatior JAN 17 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie Coun PefR114EIRQ
2300 Virginia Avenue, Fort Pierce FL 34992
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial xx Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT L-OCATION:. m ,
Address: (�S
Legal Description: REGENCY ISLAND DUNES
Property Tax ID #: 3534-111-0005-000/5 Lot No.
Site Plan Name: Block No.
Project Name: ISLAND DUNES CLUBHOUSE/RESTRAUNT
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION,OF WORK:
REROOF THE CLUBHOUSE/RESTRAUNT ONLY. REMOVE EXISTING TILE ROOF AND INSALL A
NEW TILE ROOF OVER 30# AND A SELF ADHERING UNDERLAYMENT WITH COPPER
ACCESSORY METALS. PITCH 4/12 O S O
❑ Windows/Doors
❑✓_Roof 4/12
Total Sq. Ft of Construction: _�IOC XD S'c Ft. of First Floor:
Cost of Construction: $ 45,000, Utilities:5ewer El Septic Building Height:
>OWNERAESSEE LL _
__ __
CONT
ACTOR: -
Name ii QsS
Name:
Address:
Company: ONS RE ROOFING SPECIALISTS, INC
City: State:
Zip Code: 34957 Fax:
Phone No. 979-3570
Address: 4401 SE COMMERCE AVE
City: STUART State: FH
Zip Code: 34996 Fax:
Phone No. 772-283-1505
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: INFO@ONSHOREROOFING.COM
State or County License: CCC1328994
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: xx Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: FL City: STUART State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable
Name:
Name:_
Address: 4401 SE COMMERCE AVE
Address:
City:
City:_
Zip: Phone:
Zip:_
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. 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 N Hof Commencement must be recorded and sted-on the jobsite
before the first inspection. If y tend to obtain financing, consult with lend ran attorney before
commencing work or r g Your Notice of Commencement.
Signature of r essee/Contractor as Agent for Owner
Sig ntractor/License Holder
STATE OF FL O DA
ATE OF FLORPP,
COUNTY OF
COUNTY OF
The {orgoing instF Ent was acknowled a efore me
Thefi ing instr nt
as acknowledgq fore me
t 's l ( day of
2y
t ' day of
20 Ty
NYrlie of person rDAWj
statement
NarlTe of p rson
ing statement
Personally Known
OR Produc didentification
Personally Known
OR Prod d Identification
Type of Identification
Type of Identification
Produced
Produced
Notary Public State of Florida
• Trisha Neal Hutchinson
(Signature of ry Pu
GG MINIS
S ` IoE m10/01/2021
ignatu of Pub
-
fsgr Pw. Notary Public State of FIorICe
1
Commission No.
Sea
Commis ' No.
Trish�Hutchinson
! My C on GG 14884e
anc� Expires 70/01/2021
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3-2-1
Rev. 8/2/17