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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTEd 22
Date: 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 XXWCXXX
PERMIT APPLICATION FOR:
Roof
PRoRbSED'IMPROVEMENT'LOCATION:
Address: 8606 FLORENCE DR. PORT ST. LUCIE, FL 34952
Legal Description: LA BUONA VITA COOPERATIVE UNIT/LOT 79(OR 3655-27)
Property Tax ID#: 3426-664-0078-000-4 Lot No.79
Site Plan Name: I Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRRIPTION 'OF WORK
REMOVE EXISTING ROOF AND REPLACE ANY ROT
INSTALL ASTM-226 30# UNDERLAYMENT m obi k D1q
INSTALL 26 GA METAL ROOF SYSTEM I I I
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CQNSTRUCTION,_INFORMATIO.N
Additional work to be nertormed under this permit—check all appy:
❑HVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers E]Generator Roof
Total Sq. Ft of Construction: 1,1400 Sq. Ft.of First Floor:;
Cost of Construction:$ 5,950 Utilities:0Sewer❑Septic Building Height:
OWNER/LESS CONTRACTOR:;
Name ARLENE ORTIZ Name: JOE BAKER'
Address:8606 FLORENCE DR. Company: BIG LAKE ROOFING&REPAIRS
City: PORT ST. LUCIE State:FL Address: 2699 NW'16TH BLVD
Zip Code: 34952 Fax: City: OKEECHOBEE II State:FL
Phone No.772-224-0257 Zip Code: 34972 I 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: CCC046939
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CQNSTRUCTION LIEN LAW 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: 863-763546 Zip: Phone: I
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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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 holdento 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 a I y 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:tjoom 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 Contractohr/License,Holder
STATE OF FLORIDA , t STATE OF FLORI��� � �
COUNTY OF D t.P_Z k-0 COUNTY OF l)K�� ! 0,
The forgoi g instrument was acknowledgerl hefore me The forgoing instrument was acknowledged before me
this fffKay of 20!(,-by this_A_5V-&y of 20.`(.by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of orida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Commission Heall�eflEdwardson Commission No. ���1!1i�� �%,,� Wher Edwardson
_ = COMMISSION#FF125216
;�= COMMISSION#FF125216
oma; � May 21, 2018
Revised 07/15/2011 ``��� WWW.AARONNOTARY.COM �'�a,1'Qj n lc� WWW.AARONNOTARY.COM
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