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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `i at RECEk'D juL 21 7.016 Permit Number: \C-0
i
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
PROPOSED1MPROVEMENT LOCATION:
Address: 5100 CITRUS AVE Fort Pierce, FI 34982
Legal Description: WHITE CITY BLK 42 LOTS 3 AND 4 AND N10 FT VAC ALLEY ADJ ON S (0.29 AC) (OR 2559-2696)
Property Tax ID#: 3404-501-0260-000-7 Lot No.3&4
Site Plan Name: Block No. 42
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DES.
CRIPTION OF WORK:
CAA S+v�,f+ �Ok -t res -J� �4sL.J h P\4Q ZOO�
CONSTRUCTION INFORMATION: ;
Additional work to e performed under this permit—c ec a apply:
HVAC E]Gas Tank ❑Gas Piping _Shu ❑.tters Windows/Doors
Electric 0 Plumbing Sprinklers E Generator R1 Roof
Total Sq. Ft of Construction: 2038 Sq. Ft.of First Floor:
Cost of Construction:$ 8600.00 Utilities:0 Sewer Septic Building Height:
OWNER/LESSEE, CONTRACTOR:
NameAnderson L Barron Name: Larry Neese
Address:PO Box 8146 Company: Larry Neese Roofing, LLC
City: Port St Lucie State:FL Address: 2801 Sunrise Bivd.
Zip Code: 34985 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: larry(W_LNroof.com
from the Owner listed above) State or County License: FL CCC1330608
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 thepermit 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 regording your Notice of Commencement.
//" s
_Signatu caner/Lessee/Agent Signatur of Co ractor/License Holder
STATE OF FLORIDA STATE OF FLORI
COUNTY OF �� FLORID
4,W J COUNTY OF_ - CGJ �-
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisday of 20 19 by this day of 20 +_by
(Name of knowledging) (Name of person kknowledging)
(Signature of Notary Public-S Florida) (Signature of Notary Public-Stat Florid )
Personally Known_)ZOR Produced Identification Personally Known �' OR Produced Identification
Type of Identification Produced Type of Identification Produced
7 q 0/vL�OI\JLI J
Commission No.(r(� Z l ""vP�% I �
-� HERRING Commission No. 114��
MY COMMISSION#FF140529 a M {pgq; y t0.X052
�P EXPIRES:July 10,2020 F'KP:,."2-S-J:.•
'Wbd•�WStiJ�d
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS