HomeMy WebLinkAboutBuilding Permit Application 11:
�. ALL.APPLICABLE.INFO MUST BE COMPLETED FOR APPLICATION.TO BE ACCEPTED t�
Permit Number: \1�0 3- d 3 9 3
9 8 2016
Building Permit Application
Planning and Development Services
Building and'Code Regulation Division
2300 Virginia Avenue,Fart Pierce PL 34982
Phone:(772)462-2553 Fax:(772)462-2578 Commercial Residential X
PERMIT APPLICATION FOR: Roof - me
AA
PROPOSED
PROPOSED IMPROVEME T LOCATION:.
Address: 10725 S OCEAN DRIVE UNIT 67 JENSEN BEACH FL 34957
Legal Description: HOLIDAY OUT AT ST LUCIE.BLK G LOT 28 AND EQUAL PRO-RATA INTEREST IN
COI K40N ELEMENTS(OR 260 2070)
Property Tax ID#:4511-501-0238-000-6 Lot No.28
Site Plan Name: Block No_ G
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCR,IPTIC?N OF WORK:
REMOVE EXISTING SHINGLE ROOF AND INS-TALL NEIN 5V[METAL MILL FINISH ROOF
CONSTRUCTION INFORMATION:
Additionalworklobeoerformedunder tis permit—check a appy:
L=iHa�AC I=I°
[Gas Tank Gas Piping _ShuttersDiffindowsjDoors
OE[ectric Lam'Plumbing OSprinklers ElGenerator W1 Roof'
Total Sq.Ft of Construction: 715 Sq.Ft.of First Floor:
Cost of Construction:$4=575:00 Utilities: Sewer Eleptic. Building Height:
OWNER/LESSEE: CONTRACTOR:
Name G L AND FLORA VALLEE Name: RONALD LATTA
Address:590 DUFRESNE ST Company: TREASURE COAST CONCEPTS INC_
City: LAVAL QC, H7V IY8-CANADA State:_ Address: 3458 SW PLUTO ST
Zip Code:H7lf IY8 Fax: City: PORT ST LUCIE State:FL
Phone No-.514-710-2328 Zip Code:34953 Fax:772-905-4910
E-Mail: Phone No. 772-777-8130,
Fill in fee simple Title Holder on next page(if different E Mail:TCCONCEPTS t*AOL.COM
from the Diner listed above) State or County License: CCC1330362
6f value c f construction is$2500 or more,a RECORDED Notice of Commencement is required.
1 r•,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION--
DESIGNER/ENGINEER:
NFORMATIONrDESIGNER/ENGINEER: x—Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:.
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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 w r or recording our Notice of Commencement.
'I S
_Signature of Owner/Lessee/Agent 5 gna re o ontractor/ ' ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF L > c_i COUNTY OF S
The for mg instrument was acknowledged before me The forgoing Instrument was acknowledged before me
this2_1 day of ��Vkka--, 24 LLby this as day of 'Mtx 1' ,20 by
G ' L. lrj-L� � 0 � .
ep Kao"� � 1. .- �
(Name of person acknowle W (blame of person acknowledging)
Vv/ _ - 1
(Signature of Notary Public-State of Florida) (Signature of NotaryPublic-State of Florida)
Personally Known ORP oduced.Identification Personally Known OR Pro ce E o
Type of Identification Produced �Z 1 Q is u L Type of Identification Pr z-e" t BEANNA Gly da
_ ' ' Notary Public- 2016
Commission No.�C 212�"� mission No.C �S;�7� ,. My C( xPires Oe 858761
ANDREALATTA mision#EE
MY COMMISSION#EE 21277 >q o- cmT , n National Notary Assam
.;,fro., $anoea oug � ^+
Pf.yd• Bonded Thru Notary Pubtic Underwr tem
Revised 07/15/2014
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