HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: January 17,2017 - Permit Number: ba
RECEJ`.'7D FEB 2017
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—
PROPOSED
oof—PROPOSED IMPROVEMENT LOCATION:
Address: 2311 Jo Haywood Drive Fort Pierce Florida 34946
Legal Description: Citrus Heights S/D Lot 17(OR 1016-1753)
Property Tax ID#: 1432-700-0020-000-5 Lot No.17
Site Plan Name: Block No.
Project Name: Crenshaw-1624
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
A re-roof, where we are tearing off 3-tab shingles and replacing them with GAF Sovereign 3-tab
shingles, with the existing deck to remain
CONSTRUCTION INFORMATION: _
Additional work toe e orme under this permit—check a appy:
HVAC E]Gas Tank Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing ❑Sprinklers Generator Roof 412 Roof pitch
Total Sq. Ft of Construction: 27 S . Ft.of First Floor:
Cost of Construction:$ 12,550.81 UtilitiesInSewer Septic Building Height: 1 story
OWNER/LESSEE: CONTRACTOR:
Name Willie Mae Crenshaw Name: Francis Buchanan
Address:2311 Jo Haywood Drive Company: Buchanan Services
City: Fort Pierce State:FL Address: 775 NW 57th Street
Zip Code: 34946 Fax: City: Fort Lauderdale State:FL
Phone No.(772)772-5295 Zip Code: 33309 Fax: (772)324-8090
E-Mail: Phone No. (772)905-2423
Fill in fee simple Title Holder on next page(if different E-Mail: office@pdrhelps.com
from the Owner listed above) State or County License: CCC-056685
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 recording our Notice of Commencement.
s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature o Contractor/License o der
STATE OF FL QR DA STATE OF FLOR
COUNTY OF COUNTY OF
The fKgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of �U�tt?Z G?z� 20 Eby this \ day 20 � by
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(Name of person acknowledging) (Name of person acknowledging)
U QQ '% kJMh_V_U~�
(Signature ofo ary Public-State of Florida) (Signature of N ry Public-State of Florida)
Personally Known OR Produced Identification Personally Known X- OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.PF q2�-T_-A (Seal) Commission No. (Seal)
,o�;.;a•: P�f1lt�Y I�111�� PEN
:Q MY COMMISSION#FF920758 ,, MY COMMISSION#FF92p 8
Revised 07/15/2014 =*,% �, ' EXPIRES September 22,2019 '.?o,�� EXPIRES September 22,20
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS