HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONs Lc Gwf+hour
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: / G�O �� Permit Number: 1 �O
o RECEIVED
Building Permit Application FEB 2 6 20%
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 vlrginla Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Roof III
?ROP.OSEDJMPROVEMENT:LOCATION
Address:c
Legal Description:
Property Tax ID#: �`q 10 - 862" 0003 — 000- S1 Lot No.
Site Plan Name: Block No.
Project Name: S4 LV6i e- ep,,ly02,11-i--1w5 ¢ 7 6214 %%/lit
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIONOF WORK: 3
Re -roof: Flat roofing
/quno0 gonj -Is
CONSTRUCTIQN INFORMATION:
AciclitionaiworKtobeoertormeci under this perm -c ec a app y:
11HVAC Gas Tank ❑Gas, Piping _ Shutters ❑ Windows/Doors
11Electric 0Plumbing Sprinklers Generator Roof 1/4" Roof pitch
Total Sq. Ft of Construction: 22,300 S . Ft. of First
sI Floor:
Cost of Construction: $ 193,80D.00 Utllities Sewer I1 Septic Building Height: 4,,;
OWNER/LESSEE:'_ -' =;_
CONTRACTOR
Name St Lucie County
Name: Dave WIWI
Address:2300 Virginia Ave
Company: Themes Seal Roof Systems, LLC
City: FL 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-Mail: Jdvera@thennasealroofs.00m
E-Mall:
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, of Commencement is requnea.
SUPPLE MENTAL'CONSTRUCrION'L•IEN LAW INFORMATION'.,
DESIGNER ENGINEER: x NotApplicable
MORTGAGE COMPANY:
X Not Applicable
Name:_ _
Name:
Address:___
Address:
City:
State:
City. State:
Zip: Phone
Zip: Phone:
_
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY:
4Not 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. Lucie Coun makes no representation that Is granting a permit will authorize the permit hold%f to build the subject s�rusure
which is in conflict with any pplicable Home Owners Acsoctatlon rules, bylaws 0r and covenants that may restrict or prohibit such
structure. Please consult wit�i your Home Owners Association and review your need for any restrictions which may apply.
Inconsideration 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,
accessary 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, ult with lender or an attorney before
commencing work or recording Your Notice of Commencement. n /1 �7 /
L".-
Signature of wner/ LesseeyContractor as Agent for Owner
Signature of Contractor/Uce se Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTYOF STLUCIE
COUNTYOFpe-B-ch
The forgoing Instrument was acknowledged before me
The forgoing Instrument was ackno ledge before me
this 23 day of JANUARY 20 18 by
this__�_dayof " 20by
JEREMIAH JOHNSON
DeWMW
Name of person making statement
Name of person making statement
Personally Known X OR Produced Identification
Personally Known x
_
Type of Identification JAME3 OLARBy
Type of identification ,,.;;:•;•„ JASMINE RIVEk
Produ d NOTARY FUBUC
Produced ^t commission u GG 64667
` STATE OF FLOW`3,�
�,r My Commission Expires
�''%•,';w^;�O Jonuary 22, 2021
Cttnm#fFFOP1Nt
gnature of otary Public- State of Florida )
(pnatureiof Notary Public- State of Florida)
Commission No. (Seal)
Commission No. (Seal)
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Rev. 8/2/17