HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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 x
PERMIT APPLICATION FOR: Roof
Address: 8241 Maiden Cane Place Lake Lucie, PSL 34952
Legal Description: SEC 26 TOWN 36S RANGE 40E
Property Tax ID #: PARCEL ID: 3426-703-0123-000-3
Site Plan Name: LORRAINE VLASATY
Project Name:
Setbacks Front Back: Right Side
Left Side:
Remove existing shingle roof.
Install IKO Storm Shield self -adhering modified shingle underlayment.
Install IKO Cambridge lifetime shingles per code.
PITCH 6/12
Additional work to pe nprTormea
HVAC Gas Tank
Electric ❑ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 9750.00
Name LORRAINE M VLASATY
Lot No. 109
Block No.
under this permit - check allnth apply:
❑Gas Piping IL_JI Shutters ❑ Windows/Doors
Sprinklers Generator Roof
Address: 8241 MAIDEN CANE PLACE
SFt. of First Floor:
Utilities:cnSewer Septic Building Height: 13 ft.
City: PORT ST LUCIE State: FL
Zip Code: 34952 Fax:
Phone No. 772-344-5143
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: GARY MARZO
Company: GARY MARZO, INC.
Address: 861-A SW Lakehurst Drive
City: Port St. Lucie State. FL
Zip Code: 34983 Fax: 772-465-8829
Phone No. 772-871-2489
E -Mail: gmarzoinc@aol.com
State or County License: CC -C058193
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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 vour Notice of Commencement.
K:O!Ll UA W kZu s
_ Signature of wner/ Les a Agent Signature of Co trac or ices older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCIE COUNTY OF ST LUCRE
The forgoing instrument was acknowledged efore me The forgoing instrument was acknowledged before me
this day of Inaa by this 00 day of MAY 20 1 G by
DAVID VANDERPILIER DAVID VANDERFLIER
(Name of p so acknowledging) (Name of perso ac owledging )
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. ;''_ DAVID DERFLIER Commission No. =°'aYP". VID VAI _�IhFLIER
of.... �.
* *= MY COMMISSION #FF099550 °
�;.. ;or; MY COMMISSION#FF099550
......... h 9 2018
F 9' ..... EXPIRE March
T) 39a•nt53 Floridallotaryservice.com
Revised 07/15/ (407)398-0153 FloridallotaryService.com
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DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
REVIEW
Name:
REVIEW
Address:
REVIEW
Address:
City:
State:
City:
State:
Zip: Phone:
Zip: Phone:
COMPLETE
FEE SIMPLE TITLE HOLDER: _
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
INITIALS
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 vour Notice of Commencement.
K:O!Ll UA W kZu s
_ Signature of wner/ Les a Agent Signature of Co trac or ices older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCIE COUNTY OF ST LUCRE
The forgoing instrument was acknowledged efore me The forgoing instrument was acknowledged before me
this day of Inaa by this 00 day of MAY 20 1 G by
DAVID VANDERPILIER DAVID VANDERFLIER
(Name of p so acknowledging) (Name of perso ac owledging )
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. ;''_ DAVID DERFLIER Commission No. =°'aYP". VID VAI _�IhFLIER
of.... �.
* *= MY COMMISSION #FF099550 °
�;.. ;or; MY COMMISSION#FF099550
......... h 9 2018
F 9' ..... EXPIRE March
T) 39a•nt53 Floridallotaryservice.com
Revised 07/15/ (407)398-0153 FloridallotaryService.com
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE # 4177790 OR BOOK 3855 PAGE 448, Recorded 04/08/2016 at 08:11 AM
NOTICE OF COMMENCEMENT �1
Permit No. Tax Folio No. d 171,02 4 —7� - 6)013 —wU-5
State of Florida County of St. Lucie
Me undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes,
:he following information Is provided in this Notice of Commencement.
Legal DFscri �tion of Property: (and street addres if ilable)�rsT: Gva� j T41,1 3(p s
sai �irt� �� �,►� ��� , �
General description of improvement: j6 1�r4
Owner information or Lessee Informatory If the Lessee contracted for the Improvement:
Name
Address
Interest inproperty:
Name and address of fe simple titleholder (if different from Owner listed above►:
Contractor's Name:
Contractor Address:
Phone Number:
F✓�G. � 3 5�9�3
Surety (if applicable, a copy o the payment and is attached): Amount of bond: $
Name and address: _ Phone number
Lender Name: Phone Number:
Lender's address:
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section
713.13(1)(a)7., Florida Statutes:
Name: Phone Number:
In addition to himself or herself, Owner designates of
benofs Notice as provided in Section 713.13(1)(b), Florida Statutes.
Phone number of person or entity designated by owner:
to receive a copy of the
Expiration date of notice of commencement: (the expiration date may not be before the completion of construction and final payment to the
contractor, but will be 1 year from the date of recording unless a different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR
RECORDING YOUR NOTICE OF COMMENCEMENT.
tinder penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of
ny know) ge and belief.,
(Signature of Owner or Lessee, or is or Lessee's Authorized Officer/Director/Partner/Manager
'ALL-L�
(Signatory's Title/Office)
The foregoing Instrument was acknowledged before me thls—�— day of 2011/
By / as for
Name of P f o I er`t� ee) Party on behalf of w m instrument was executied
` DAVID VAN RF4LIE�i
€`....',
?• MY COMMISSION SFF099550 Personally known_or produced Identification
(Signature of otary P State of FI 1 EXPIRES March 9, 2018
a
(Print, Type, or Stamp Commissioned N Rfijy PUblie)IdaN01e SBNka.00m Type of Identification produced
i1,