HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:LO
RECmvcm
Building Permit Application
JAN 2 7 2016
Planning and Development Services PERr,AITfING
Building and Code Regulation Division St. Lucie County, FL
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:'
Addresc. 3804 PEBBLE BEACH LANE, PORT ST L,UCIE FL. 34952
Legal Description: SEC 25 TWN 36S RANGE 40 E
Property Tax ID#: 3425-705-0118-000-8 Lot No.
Site Plan Name: Block No.
Project Name: SIPE RESIDENCE
Setbacks Front Back: Right Side: Left Side:
DETAILEDDESCRIPTION OF WORK:,
REMOVE EXISTING SHINGLED ROOF. INSTALL SOPREMA RESISTO SHINGLE
UNDERLAYMENT . INSTALL IKO CAMBRIDGE SHNGLES. 2/12 PITCH
CONSTRUCTION INFORMATION:-
Additional
ORMATION:A itiona work to be ertormed under this permit—check all apply:
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers ❑Generator Roof
Total Sq. Ft of Construction: 1771 S Ft.of First Floor:
Cost of Construction:$ 5,400.00 Utilities:Sewer❑Septic Building Height: 12 FT
OWNER/LESSEE_: :CONTRACTOR:
Name LARRY&PATRICIA SIPE Name: GARY MARZO
Address:3804 PEBBLE BEACH LANE Company: GARY MARZO INC
City: PORT SAINT LUCIE State:FL Address: 861 A-SW LAKEHURST DRIVE
Zip Code: 34952 Fax: City: PORT ST. LUCIE State: FL.
Phone No.989-615-1853 Zip Code: 34983 Fax: 772-465-8829
E-Mail: 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-CO58193
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEWLAW 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 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.
vvul�� A-M r_'q� s
_Signature of ner/Lessee Agent Signature of Co r ctor/Licen older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The for/going instrur gent was acknowledged before me The forgoing instrument was acknowledged before me
a
this Rf day of VfflW&W 20 &by this Z' day of 1ANUARY 20 by
DAVID VANDE41ER DAVID VANDERFLIER
(Name of person ack ow gi (Name of person acknowledging)
"X/
Signature, NotaryPublic State of Florida ) —(Signatur N6tar ;Public" ' to of=,Florida )
Personally Known x ^ Q•R Produced en I Ica Ion Personally np duced Identification
DAVID VANDERFL '�
o,..........
Type of Identificatio fro cid Type of Id at:q'�
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=� MY COMMISSION#FF099550 - � MY CO SER
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Commission No. '' 6F' °"' EXPIRE &rch 9, 2018 Commissi n F � �X�,b�� __ N#FFpg@W�
(407)$98-0153 FloridallotaryService.com (407)398-0153 arch 9.2018
Flo ri6eNotn Service.co
Revised 07/15/2014
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