HomeMy WebLinkAboutBuilding Permit Application I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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
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PROPOSED IMPROVEMENT LOCATION. ri „ t „I
Address: 5139 Margaret Ann LnFort Pierce, FL 34946
Legal Description: GREEN ACRES S/D BILK 1 LOT 11 (OR 2320-1979: 3242-2451)
Property Tax ID#: 1430-700-0011-000-3 Lot No.11
Site Plan Name: Block No. 1
Project Name: j
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:,
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CONSTRUCTION.INFORMATION `
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Additional work toe e orme under this permit—check k a appy:
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HVAC fl Gas Tank 0Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing []Sprinklers Generator Roof
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Total Sq. Ft of Construction: 1296 S . Ft.of First Floor:
Cost of Construction:$ 13,500.00 Utilities: _Sewer E]S ptic Building Height: z
OWNER LESSEEn CONTRACTOR IF `'} r^
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NameArthur H Gebo Name: Larry Neese ,
Address:5139 Margaret Ann Ln Company: Larry Neese Roofing, LLC
City: Fort Pierce State:F� Address: 2801 Sunrise Blvd.
Zip Code: 34946 Fax: City: Fort Pierce State: FL
Phone No. Zip Code: 34982 Fax: 772-361-6581
E-Mail: Phone No. 772-361-6580
Fill in fee simple Title Holder on next page(if different E-Mail: larrya-LI Nroof.com
from the Owner listed above) State or County License: FL CCC 1330608
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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INFOR
SUPPLEMENTALCONSTRUCTION,LIENL
, AW MATION: l, a
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DESIGNER/ENGINEER: Not ApplicableMORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: PI hone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address: I
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 A endments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pool nces,walls,signs,screen rooms and accessory uses to another non-reside I use
WARNING T R: r failure to Record a Notice of Commencement I n your ying twice for
improv nts to ur roperty.A Notice of Commencement must ecorded d p ed on the jobsite
bef the firs ' spe ion. If you intend to obtain financing, co t with le r orla attorney before
c men ' rk o recording our Notice of Commencem
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_Si nature o�ORIDA
essee/Agent Signature of Co ract Ir/Lic se Holder
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ST E STATE OFF=A-/-
COUNTY
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COUNTY OFA COUNTY OF ����, Q
The forgoing instr ment was acknowledged before me The forgoing instr ment was acknowledged before me
thi&'5--day of 201k,,,—by thisa day of 20 16 by
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(Name f perso acknowledging) (N of persona owledging)
turb of Notary Public-Stat of Florida) ignature of NotaryPublic-kate of Florida)
Personally Known OR Produced Identification Personally Known ! OR'Produced Identification
Type of Identification Prod ced Type of Identification Produced
sad- • ay I.
Com–mission No. (Seal) Commission No. (Seal)
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Revised 07/15/21014RFR&- WAir,
LASHAHNA INGRAM
otary Public State of Florida.x fires Dec 20,2018C mmission#FF 177 49REVIEWS FRONTnde l$AEpaVd19DRlfayA NS VEGETATIONSEA TURTLE MANGROVE
COUNTERW REVIEW J REVIEW REVIEW
DATE
COMPLETE
INITIALS
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