HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �O� -,�5• �� Permit Number: �S • 4/ � �
RECEIVEE
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Building Permit Application DEC 18 2015
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: 5112 LA Salle st Fort Pierce FI 34982
Legal Description: LAKEWOOK PARK-UNIT 12-A-BLK 173-A LOT 7 (MAO 13/13N) (OR 661-2606)
Property Tax ID#: 1301-615-0131-000-2 Lot No.7
Site Plan Name: Block No. 173
Project Name: ORR
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
- REMOVE AND REPLACE ROOF SHINGLES / ROOF PITCH 4/12
- REMOVE AND REPLACE TORCH DOWN FLAT ROOF / ROOF PITCH 1/12
CONSTRUCTION INFORMATION:
Additional work toe nertormed under this permit—c ec a appy:
HVAC0 Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
0 Electric 0 Plumbing Sprinklers ElGenerator FV] Roof
Total Sq. Ft of Construction: 2.400 1
S . Ft. of First Floor: 2.400
Cost of Construction:$ 8,500 Utilities:11 Sewer Septic Building Height: 8'0"
OWNER/LESSEE: CONTRACTOR:
Name FRANFLIN T ORR Name: MAURICIO ORELLANA
Address:5111 BUCHANAN DR Company: ONE CONSTRUCTION&ROOFING CONTRACTORS
City: FORT PIERCE State:FL Address: 3437 SW EUROPE ST
Zip Code: 34982 Fax:N/A City: FORT PIERCE State:FL
Phone No.359-2939 Zip Code: 34953 Fax:
E-Mail:N/A Phone No. 772-519-2449
Fill in fee simple Title Holder on next page(if different E-Mail: ONECONSTRUCTIONSERVICES@YAHOO.COM
from the Owner listed above) State or County License: CCC- 1330623
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: XX Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: P e: Zip: Phone:
FEE SIMPLE LE HOLDER: _Not Applicable BONDING COMPANY: X 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 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 financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
GJJJI L&_0 sllzLc-�_C) OJ_&k S
_Signature of Owner/Lessee/Agent ; , Signature of Contractor/License Holder
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STATE OF FLORIDA3 STATE OF FLORIDA
COUNTY OF ST LUCIE COUNTY 1 COUNTY OFRT—
The forgoing instr ent was acknowledged befo 'e' i The forgoing g instrument was acknowledged before -C
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this day of 20,[7b �;
� this day of_� ( 20 by 2 ms m
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(Name of person acknowledging) !R Q (Name of person acknowledging) o
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(Signature f oary Public- tate o Florid (Signature of No Public-State of Flor a)
Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
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