HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
,. F -;:-,4 - RECEIVE®
6060
Building Permit Application MAS i 2016
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
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT:LOCATION
Address: 41 Vista de Laguna, Fort Pierce, FL 34951
Legal Description: Spanish Lakes Country Club.-SECT 6 TWP 345 RANGE 39E
Property Tax ID#: 1301-111-0001-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAI'LfED:DESCR1PT)ON. OF WORK
Reroof- Remove existing roof covering, Dry-in and install new asphalt shingles.
Roof Pitch-2 1/2 / 12
Product Approval- Owens Corning FL# FL10674-R10
CONSTRUCTION INFORMATION'.
Additionalwork to be nertormed under this permit–check all t=appy:
HVAC Gas Tank E]Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing ]Sprinklers Generator 0—Roof
Total Sq. Ft of Construction: 1200 S . Ft.of First Floor:
Cost of Construction:$ 4725 Utilities:liSewer Septic Building Height:
OWNER/LESSEE: TO
CONTRACRN
Name Tom Boal&Winn Corp Name: Michael Miller
Address: 12804 SW 122nd Ave Company: Trade Winds Roofing, Inc
City: Miami State:FIL Address: P.O. Box 13208
Zip Code: 33186 Fax: City: Fort Pierce State:FL
Phone No.705-789-6659 Zip Code: 34979 Fax: 772-466-9725
E-Mail: Phone No. 772-466-9420
Fill in fee simple Title Holder on next page(if different E-Mail: Mike@tradewindsroofing.com
from the Owner listed above) State or County License: CC C057399
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
"SUPPLEMENTAL CONSTRUCTION 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
commencindwork ormcording your Notice of Commencement.
f��J s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF J L—UC ` 4Q_ COUNTY OF S L0C
The forgoing instrument w s acknowledge before me The fo going instrument was acknowledged before me
this�day of 20 acknowledged
this X day of `Y CL( Cf 20 ]R by
ft�o-(\(I �1��J Y_ __ a k Q-ha M�A I _�_
(Name of person acknowledging) (Na a of person acknowledging)
(Signature of Notary Publi -Stat of Florida (Signature of Notary PublicState ofJFlorida)
Personally Known_�ZOR Produced Identification Personally Known L✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. AVIIXA&
AKI FELCWW
GANDEE Commission No. FEW9 GANDEE
STATE OP FLORIDA IC NOTARY PUBLIC
. Conner FF05120 CamdR FF051263
Revised 07/15/2014 Expires 9/4/2017
Expires 914/2017
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS