HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: a-•�I' �J Permit Number:
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Building Permit Application DEC 2
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:
OCATION:Address: 1704 N 43RD ST. FORT PIERCE, FL 34947
Legal Description: SUNLAND GARDENS-SECTION 4-BLK 46 LOT 19(0.19 AC) (OR 1913-2936)
Property Tax ID#: 2406-506-0025-000-6 Lot No.19
Site Plan Name: ADAMS Block No. 46
Project Name: ADAMS
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REMOVE AND REPLACE SHINGLE ROOF.
ROOF PITCH 4/12
CONSTRUCTION INFORMATION:
Additional work to be nertormed under t ispermit—c ec all appy:
HVAC Gas Tank F_]Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 1181 S . Ft. of First Floor: 1181
Cost of Construction:$ 4,800 Utilities: Sewer Septic Building Height: 80
OWNER/LESSEE,-'OWNER CONTRACTOR:
Name CHERRY ADAMS Name: MAURICIO ORELLANA
Address: 1704 N 43RD ST Company: ONE CONSTRUCTION&ROOFING CONTRACTOR
City: FORT PIERCE State:FL Address: 3437 SW EUROPE ST
Zip Code: 34947- Fax: City: PORT SAINT LUCIE State:FL
Phone No.772-466-4349 Zip Code: 34953 Fax: 772-336-9379
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: CGC-1515745
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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'SUPPLEMENTAL CONSTRUCTION LIE°N=LAW INFORMATION`..
DESIGNER/ENGINEER: X Not Applicable 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: 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.
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFCOUNTY OF
The forgoing ins . ment was acknowledged bore me The for oing in ument was acknowledged before me
this day — 20 �by thi;day o 20/_5by
(Na a of person acknowledging) (Nam4 of person acknowledging)
(Signature of Notary Pu lic- a of Florida) (Signature of Nota�. OSR
of Florida)
Personally Known OR Produced Identification Personally Known duced Identification
Type of Identification Produced T e of Identification Produced
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