HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONM�
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a1\�\� SCANNED Permit Nu oa-dbl
BY ECEIVED
Kffi� r St. Lucie County FEB 0
- - 12018
Building Permit Applicati 91,
Planning and Development5ervfces Lucie County, P®rmltting
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: Roof
Address: 90-11
Legal Description:
Property Tax ID #: 2428-111-0001-000-8
Site Plan Name:
Project Name: Facilities Administration Bldg Re -roof
Setbacks Front Back: Right Side:
DETAILED DESCRIPTION OF WORK:
Re -roof: Flat CCO�k�
OHVAC LJGasTank ❑Gas Pi
OElectrlc OPlumbing ❑Sprini
Total Sq. Ft of Construction: 6,200
Cost of construction: $ 80,000.00
M
Left Side:
Lot No.
Block No.
ng ❑_ Shutters ❑Windows/Doors
rrs 1n
1Generator ZRoof E° Roof pitch
S Ft. of First Floor:
Utilities.: Sewer 0 Septic Building Height: 15%_
OWNER/LESSEE:
CONTRACTOR:
Name St Lucie County
Address:2300 Virginia Ave
Name: Dava Wiket
Company: Thetme Seal Roof Systems, LLC
City: Ft. Pierce State: FL
Zip Code: 34982 Fax:
Phone No...
Address: 1421 Oglethorpe Rd
City: West Palm Beach State: FL
Zip Code: 33405 Fax:
Phone No. 561-223-2096
E-Mall: Jrivero@thermasealroofs.com
E-Mail:
Fill In fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: CCC1325862
If value of construction Is $2500 or more, a RECORDED Notice or commencement is requaea.
SUPPLEMENTAL CONSTRUCTION_LIEN LAW INFQRMATION*
DESIGNERANGIiNEER: —Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Address:
City:. State:
Zip: Phone
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name: _
Address:
BONDING COMPANY: _Not Applicable
Name:
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. Lucie County makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in con 1ct with any applicable Home Owners Association rules, bylaws or an 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 % an attorney before
commencing work or recordine vour Notice of Commencement; , /I //
Z
L)�LILZ
ignatur of Owner/ a/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA ST. LUCIE
STATE OF FLORIDA
COUNTY OF
COUNTY OF Pohr>-,h
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledge before me
this 22 day of JANUARY 20 18 by
this_L_dayof Fe Irl V1 _1b by
JEREMIAH JOHNSON
oaswtei
Name of person making statement
Name of person making statement
Personally Known X OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identifiatfon
PmducjM oe
Produced JASMINE RIVE RA
3� .<- Commission 0 GG 64667
�'® ,ogyrs My Commission Expires
w„,,,„;,`,..° January 22, 2021
( nature of otary Public- State of Florida )
)
(i of Notary Public -State of FloridaJAMES
Commission No. FF094406 WVARY PUBW
Commission No. (Seal)
STATE OF FLORIDA
Comrrq FF09410B
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Rev.8/2/17
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