HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: s7rc
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 x
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 330 N. BROCKSMITH RD., FORT PIERCE FL. 34945
Legal Description: SEC: 08 TWN :35 S RANGE 30 e
Property Tax ID#: 2308-123-0001-000-6 Lot No.
Site Plan Name: Block No.
Project Name: STEPHEN OR KAREN SURRENCY
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REMOVE EXSITING SHINGLED ROOF. INSTALL SOPREMA RESISTO METAL
UNDERLAYMENT DIRECT TO DECK. INSTALL GULF COAST SUPPLY 5V METAL PER CODE.
CONSTRUCTION INFORMATION:
Additional work to be nerformed under t ispermit—check all that appy:
HVAC Gas Tank Gas Piping _Shutters Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 3762 SFt. of First Floor:
Cost of Construction:$ 16,750.00 Utilities:Sewer OSeptic Building Height. 13
OWNER/LESSEE: CONTRACTOR:
Name STEPHEN OR KAREN SURRENCY Name: GARY MARZO
Address:330 N.BROCKSMITH RD. Company: GARY MARZO, INC.
City: FORT PIERCE State:FL Address: 861 A-SW LAKEHURST DRIVE
Zip Code: 34945 Fax: City: PORT ST. LUCIE State:FL.
Phone No.772-201-1729 Zip Code: 34983 Fax: 772-465-8829
E-Mail:SRSC00@AOL.COM Phone No. 772-871-2489
Fill in fee simple Title Holder on next page(if different E-Mail: GMARZOINC@AOL.COM
from the Owner listed above) State or County License: CC-C058193
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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 TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counter 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 financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
b"VA s
_Signature of ner/Less Agent Signature C ntractor/LikpZe Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST.LUCIE COUNTY OF ST.LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 6 day of 20/�by this z day of SEPTEMBER 20 by
cud I ox-
(Name of person ac v jec#gi ) (Name of person acknow )
(Signature of Notary c-State of Florida) (Signature of Notar ub'c-State of Florida)
Personal) Known tion Personally Known OR Produced Identification
Type of Iep
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DAVID
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407)398-0153 FloridallotaryService.com (4071300-0153 FlarldaNdtifySarylognm
Revised 07/15/2014
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