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ALL APPLICABLE INFO �MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ��) •/ Permit Number: /00, �! r
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RECEIVE®
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Building Permit Application MAY 19 2016
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (77i)462-1553 Fax: (772)462-1578 Commercial Residential XXXXcXXX
PERMIT APPLICATION FOR: Roof
PRO`POSED.. M:PROVEMENT-LOCATI01� t,
Address: 511 BARB ANN LN PORT ST. LUCIE, FL 34952
Legal Description: LA BUONA VITA COOPERATIVE UNIT/LOT 138(OR 3012-890:3513-76)
Property Taxi ID#: 3426-664-0134-000-5 Lot No. 138
Site Plan Na e: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILEEWESCRIPTION'OF WORK
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REMOVE EXISTING ROOF
REPLACE ANY ROT
INSTALL ASTM-226 30# UNDERLAYMENT
INSTALL 26 GA METAL ROOF SYSTEM ONE,/1'1§ M;OBILMRWME
CON STR UECTI O.kl N FORM ATI ON
Additional Work toe performed under this permit—check all appy:
HVAC 0 Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
❑Electrc 11PlumbingSprinklers ❑Generator 7 Roof
Total Sq. Ft of Construction: 1,100 S . Ft.of First Floor:
Cost of Construction:$ 4,975 Utilities:tSewer Septic Building Height:
01NNE VLESSEE:.' CONTRACTOR: .
Name JAMES&SANDRA COY Name: JOE BAKER
Address:511BARB ANN LN Company: BIG LAKE ROOFING&REPAIRS
City: PORT ST. LUCIE State:FL Address: 2699 NW 16TH BLVD
Zip Code: 34952 Fax: City: OKEECHOBEE State:FL
Phone No.7172-678-1483 Zip Code: 34972 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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SUPPL�ENIE�NTAL`,CONSTRUCTION'LIEN;LAW INF:OR•MATIO:N`:•;
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: ASMUSSENENGINEERINGLLC Name:
Address:P-o.Box 1998 Address:
City: OKEECHOBEE State: FL City: State:
Zi.p: 34973-19981 Phone: e63-7rM546 Zip: Phone:
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FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: I Address:
City: I City:
Zip: I 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 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 iwith 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 strulctures,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.
Signature ofOwner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA ( � STATE OF FLORIDA
COUNTY OF COUNTY OFD 6M
Theorgoinglinstrument was acknowledged hefore me The forg°�I,�ng instrument was acknowledged before me
this lm-I�y of 20� t
by this `day of 20] io by
Tom a i-c r �o e- a K-e'r
(Name of person acknowledging) (Name of person acknowledging)
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(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known_�'/ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Commission No.
( her Edwardson p. Moir Edwardson
COMMISSION#FF125216COMMISSION#FF125216
May 21, 2018
Revised 07/15/2014 0iiiWWW.AAAONNQTARY.COM S.4*-'i, WWW,AARQNNQTARY.CQM
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