HomeMy WebLinkAboutBuilding Permit Application ..:�.APPL17LE INFO MUS BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: C Permit Number:
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 XXXXXXXX
PERMIT APPLICATION FOR: Roof
PR. P EDIMPROVEMENT LOCATION
Address: 490 ANN MARIE CIRCLE,PORT ST. LUCIE, FL 34952.
Legal Description: LA BUONA VITA COOPERATIVE UNIT/LOT 191 (OR 3655-128:3750-1206)
Property Tax ID#: 3426-664-0185-000-7 Lot No.191
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
REMOVE ROOF REPLACE ANY ROT
INSTALL ASTM-226 30# UNDERLAYMENT 06 . k e,
INSTALL 26 GA METAL ROOF SYSTEM
CONSTRUCTION INFORMATION
Acid i lona I work to (epe Orme under this permit-c ec a appy:
HVAC !=J Gas Tank ❑Gas Piping _Shutters a Windows/Doors
oElectric 0 Plumbing F Sprinklers Generator 7 Roof
Total Sq.Ft of'Construction: 1,600 Sq.Ft.of First Floor:
Cost of Construction:$ 6,400 Utilities:Sewer F]Septic Building Height:
OVVNERJLESSEE: CONTRACTOR',
Name GERDA GRIMM . Name: JOE BAKER
Address:490 ANN MARIE CIRCLE Company: BIG LAKE ROOFING&REPAIRS
City: PORT ST. LUCIE State:FL Address: 2699 NW 16TH BLVD.
Zip Code: 34952 Fax: City: OKEECHOBEE State:FL
Phone No.772-521-0574 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: CCCO46939
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION, LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: ASMUSSEN ENGINEERING LLC. Name:
Address:P-o.Box 1998 Address:
City: OKEECHOBEE State: FL City: State:
Zip: 34973-1998 Phone: 863-763-8548 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 County makes no representation that is granting a permit will authorize thepermit 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 l 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.
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Signature of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLOR�IDA�,, STATE OF FLO
VRIpQ
COUNTYOF ,44,6,,,Ehu COUNTY OF Z.F:rn ®�-QP
The forgo'ng instrument was acknowledged before me The forgoing instru ent was acknowledged before me
this %y of a 20!(p_by this ay of 20]4v by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced N� Type of Identification Produced
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