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ALL APPLICAkLlf INFO USTBECOMPLETED FOR APPLICATION TO BE ACCEPTED (�
Date: Permit Number:
V
•
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 Residential XXcXXXXX
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVE MENTLOCATICN:
Address: 28 AZUL FT. PIERCE, FL 34951
Legal Description: SPANISH LAKES COUNTRY CLUB
Property Tax ID#: 1301-111-0001-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DM
DET WORK f
REMOVE EXISTING ROOF
REPLACE ANY ROT
INSTALL ASTM-226 30# UNDERLAYMENT
INSTALL 26 GA METAL ROOF SYSTEM ��4
CONSTROCTION.1NFORMA TION
Additional work to be nertormed under this permit—check all appy:
HVAC _Gas Tank ❑Gas Piping _Shutters a Windows/Doors
Electric Plumbing Sprinklers ElGenerator W1 Roof
Total Sq. Ft of Construction: 1,600 S . Ft.of First Floor:
Cost of Construction:$ 6,450 Utilities: Sewer F]Septic Building Height:
OWNER/L-ESSEE f - RACTOR
Nam Name: JOE BAKER
Addresses Styes Iy; BIG LAKE ROOFING&REPAIRS
City: F��="��R� 1cwv\ State:FL Address: 2699 NW 16TH BLVD
Zip Code: 3 " ax: City: OKEECHOBEE State:FL
Phone No. Zip Code: 34972 Fax: 863-763-7662
E-Mail: Phone No. 863-763-7663
Fill in fee simple Title Holder on next page(if different E-Mail: BIGLAKEROOFING@YAHOO.COM
from the Owner listed above) State or County License: CCC046939
[=
f value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SSU'JPPLEMpENTALCONSTRUCTIO`N LIEN LAIN INFORMATION
*•
DESIGNER/ENGINEER: =Not Applicable MORTGAGE COMPANY: xxx Not Applicable
Name: ASMUSSEN ENGINEERING Name:
Address:600 S PARROTrAVE Address:
City: OKEECHOBEE State: FL City: State:
Zip: 34974 Phone: 863-763.8546 Zip: Phone:
FEE SIMPLE TITLE HOLDER: _lot Applicable BONDING COMPANY: xxx Not Applicable
Name: lJ y r S 0 i 1 d�Yxe\ C-Or'P- Name:
Address: 1 �_ 6 L)1--f W d a o nd ijf Address:
City: AA , a-nn i L- City:
Zip: 5z Io Ph ne: Zip: Phone:
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 jobsite
before the first inspection. If you intend to obtain financirtg, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
9- /
Signature of Owner Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA r-
COUNTY OF__Q -P ( p COUNTY OF
Thef1o,�r o,'{,ng instrument was acknowledged before me The forgoing instrument was acknowledged before me
this M n .b,y of 20 16 by this flay of 20_L6 by
ms
�ctz- Ea Ik-e�- �S D-,f
(NameUf person (Name of person acknowledging)
�Z/Co t
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florl a)
Personally Known_ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. �,`p ' ri%, Commission No. cher Edwardson
Hher Edwardson
COMMISSION 0 FF126216 CMM
=, �,ttNd•r018EXPIRES: May 21, 2018
Revised 07/15/2014 '���, „r1�`` WIIYW.AARONNOTAAY.CoM `��, ��`�� WWW.AARONNOTARY.COM
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