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ALL APPLICABLE INFO MUST BE COMPLETED.FOR APPLICATION TO BE ACCEPTED
11
Date: � .7 ! [� Permit Number: PCs
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Building Permit Application AUG 0 5 Wlu
Planning and Development Services PERNII�11 ING
Building and Code Regulation Division St. Lucie County; FL
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: 211 N 40th ST Fort Pierce, FL 34947
Legal Description: WILBUWE BILK 5 S 30 FT OF LOT 13 AND N 45 FT OF LOT 14(0.22 AC) (OR 1159-1860)
Property Tax ID#: 2408-603-0053-000-5 Lot No.13&14
Site Plan Name: Block No. 5
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION''DF WORK:-
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CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—checka appy:
HVAC E]Gas Tank Gas Piping _Shutters Q Windows/Doors
11 Electric 7 Plumbing Sprinklers Generator R1 Roof
Total Sq. Ft of Construction: 1492 S Ft.of First Floor:
Cost of Construction:$ 3100.00 Utilities- Sewer Septic Building Height:
OWNER/LESSEE: . CONTRACTOR:
Name Earl S Gardner Name: Larry Neese
Address:1701 N 35th St company: Larry Neese Roofing, LLC
City: Fort Pierce, State:FL Address: 2801 Sunrise Blvd.
Zip Code: 34947 Fax: city: Fort Pierce State: FL
Phone No.—n A — 0'314— La9L(I 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[aD_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.
:SUOLEMENTAL 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,fence s,sig s,screen rooms and accessory uses to another non-reside tial use
WARNING TO OWNER:Your fai a to Record a Notice of Commencement may result in yo aying twice for
improve s to yo r prope .A Notice of Commencement ere rded and osted on the jobsite
befor a first ins ction. If ou intend to obtain financing, onsult with Id
or n attorney before
corn en, w cor n our Notice of Commencem 2
s
_Signat a of Own essee gent Signatur f�Contract /Li se Holder
STAT FLORIDA � yy ST E _
COUNTY OF `1 i �,?0,IF COUNTY OF f 101t
The forgoing instrwas a nowledged before me The forgoing inst ment was cknowledged before me
this�day of ment 20 116 by this-5—day of 20 by
OEra2
(Name of person ac owledging) (Name of persona nowledg' g) _
(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 {� L Type of Identification Produced n.L.-
Commission NO. J .``''Rr������(SeXAREN S. NIELSE CO ISSIOn NO. y�
AR N S. NIELSEN
`• "= Commission N FF 115 37 �°'"r'u�ioS
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P, My Commission Ex it s _� *_ Commission M FF 115637
2018 `; pires
Revised 07/15/2014
' � June 12, 2018
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS