HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: Ci' !� I
RECEIVED
a
Building Permit Application JAN 2 7 2016
Planning and Development Services PERMITTING
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,:
Address: 79 S. LAS OLAS DRIVE JENSEN BEACJ FL.
Legal Description: BEACH CLUB COLONY- SEC 11 TWN 37 S RANGE 41 E
Property Tax ID#: 4511-500-0049-000-1 Lot No.
Site Plan Name: Block No.
Project Name: TANKE RESIDENCE
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
REMOVE EXISTING SHINGLED ROOF. INSTALL SOPREMA RESISTO SHINGLE
UNDERLAYMENT . INSTALL OWENS CORNING SHNGLES(3/12
CONSTRUCTION INFORMATION:
Additional work to beE,performed un ert ispermit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing ❑Sprinklers E]Generator [z] Roof
Total Sq. Ft of Construction: /7`/ S . Ft. of First Floor:
Cost of Construction: $ 5,950.00 Utilities: Sewer[]Septic Building Height: 12 FT
OWNER/LESSEE: .CONTRACTOR:'.
Name EVELYN TANKE Name: GARY MARZO
Address:79 S. LAS OLAS DRIVE Company: GARY MARZO INC
City: JENSEN BEACH State:FL Address: 861 A-SW LAKEHURST DRIVE
Zip Code: 34997 Fax: City: PORT ST. LUCIE State:FL.
Phone No.609-760-4104 Zip Code: 34983 Fax: 772-465-8829
E-Mail:EVETANKE@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.
SUPPLEMENTALCONSTRUCTION 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 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.
�1� M-4� 9,_� (�!� s
_Signature cf vainer/Les a/Agent Signature of C n raftor/LidERge Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The forgoing instruMoLwas acknowledged before me The forgoing instrument was acknowledged before me
this 4 day of t_1 20 �&by this 21 day of JANUARY 20 by
DAVID VANDERRIER DAVID VANDERFLIER
(Name of person acknowleggin (Name of person acknowledging)
e
I �
:. (Sign IVrk , Motary=Public-State of Florida) �-(Signature;of N.gtary>Publ'ic ate of Florida)
pjiv n�a,.
Personally Kno n :a:,�PVb®uYEi Personal) K x tion
._; va�fA��E�� �
Type of Identifi tton od€ac COMMISSION#FFo99'aa0 Type of I eiatiif' tioP Pr'�q��'r5lnyltsst�ry#FF099
EXPIRES March 9, 2099 =",KyaFoQ:' EXPIRES March 9, ���
Commission No.�An7�"�gq.0153 Floridallota4�@alle.com Commiss
(ao ) n a o aryService.com
Revised 07/15/2014
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