HomeMy WebLinkAboutBuilding Permit Application i II
ALL APPLICABLE INFO) MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1�• �o Permit Number: ��A 0• 0_zY 61
- -
Kwels EON
Building Permit Application
Planning and Development Services JUL
1 3 1016
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
PROPOSED IMPROVEMENT LOCATION:
Address: 123 QUEEN ANN COURT, FORT PIERCE FL. 34949
Legal Description: SEC 14 TWN 34 S RANGE 40 E
Property Tax ID#: 1414-701-0202-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REMOVE EXISTING SHINGLED ROOF r
INSTALL RESISTO LASTOBOND MODIFIED UNDERLAYMENT
INSTALL GULF COAST OCEAN GUARD .032 5V METAL
INSTALL 5 NEW MAXIM SFA SKYLIGHTS
4/12 PITCH
CONSTRUCTION INFORMATION:
Additional wor to be e orme un er t ispermit—check all appy:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers Generator W1 Roof
Total Sq. Ft of Construction: 4193 S . Ft. of First Floor:
Cost of Construction:$ 33,100.00 Utilities:n Sewer Septic Building Height: 18 FT
OWNER/LESSEE:: CONTRACTOR:
Name JIM&BETSI HILL Name: GARY MARZO
Address:123 QUEEN ANN COURT Company: GARY MARZO, INC
City: FORT PIERCE State:FL Address: 861 A-SW LAKEHURST DR
Zip Code: 34949 Fax: City: PORT ST LUCIE State: FL
Phone No.757-646-4073 Zip Code: 34983 Fax:
E-Mail:GCROSS01@COMCAST.NET Phone No. 772-871-2489
Fill in fee simple Title Holder on next page (if different E-Mail: GMARZOINC@AOL.COM
from the Owner listed above) State or County License: CC-C058193
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION•LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: 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 work or recording our Notice of Commencement.
t , s
wn /Lessee/Agent
_Slgna
s-a tuceaofSignature-o ontr cto /License Hold
�O
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST.LUCIE COUNTY OF ST.LUCIE
The for�joing instrum t as acknowledged before me The forgoing instrument as acknowledged before me
this `7S day of 20 ,[ by this g day of �'� L 20 Ik by
(Name of p on a ing) (Na of per o a nowledging)
(Slgnature'o" otary blit-State of Florida) ((. 'g•#ure,�f Notary Public-State of Florida)
Personally Known x ORP Personally Known x OR Produced Identification
Type of Identificat on,,PXace DERFLIE Type of Identific lo,.Pp
'_ - •.ti- DAVID VANDERFLIER
`,; +' MY COutltld
MMISSION#FF099550
Commission No. - `= r=XpIRES(iC" h 9,2018 Commission No. "`. 1 MY COMM ISSICIIS 099550
`•'.! - o,,. EXPIRES March 9,2018
Flo ridallotaryService.com oo Fl,,,
(407139B-0 (4071398-0153
Revised 07/15/2014
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