HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED [�
Date: Permit Number: ( `®� - ()lLJ
SCANNED RE{"D
BY
•alit St. Lucie Countv MAY 06 Y019
Building Permit Applicationermitting Department
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Yes Residential
PERMIT TYPE:
PROPOSED°IMPROVEMENT L'OCATION:,
Address: 4601 Old Dixie Hwy, Ft, Pierce, FI 32946
Property Tax ID ft: 1414-601-0002-010-2 Lot No.
Site Plan Name: Block No.
Project Name:
.DETAILED DESCRIPTION OFINORK "
,z
Complete removal of the existing roof covering and install new shingle roof over new self ashesive roofs underlayment
CONSTRUCTION INFORIVIATIONsr"`
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _Shutters —Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof 5/12 Pitch
Total Sq. Ft of Construction: 7500 sq ft of roof area Sq. Ft. of First Floor:
Cost of Construction: $ 29,400 Utilities: -Sewer _Septic Building Height: 20
,OWNER/LESSEE: °. �:
CONTRACTOR:,
Name Y
Name:Raul Licona
Address:,
Company: Dependable Roofing Systems, inc
City: State: _
Zip Cade: Fax:
Phone No.
Address:835 33rd Court SW
City: VeroBeach State:FI
Zip Code: 32968 Fax: 772 2990658
Phone N0772 569 0880
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail VLL7598@BELLSOUTH.NET
State or County License
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
J SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
_ 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. 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 B SITE BEFORE THE FIRST INSPECTION. IF YOU INT TO OBTAIN FINANCING, CONSULT
WITH R LEND OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
/�✓
X
Signatqte of Owner see/Contractor as Agent for Owner
Signat UIT of Contractor/Dcense'l4older
STATE OF FLORIDA
STATE OFF ORIDA
COUNTY OF Skit +
COUNTY OF
The forgoing instrument was acknowledge before me
1
The forgoing instrument was acknowledged before me
� by
this day of 0 20� by
tl
this day of MQ 0
Ago I• nr A�
Name of person making statement.
Name of person making statement.
Personally Known U OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
b-w4 LYE
Produced {�
0%
(Signature of Notary Public- StaM of Florida) v
(Signature of Notary Public- kate of Florida)
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. TM 19