HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/28/17 Permit Number:
IV
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.IMPROVEMENT LOCATION:
Address: �J f C� '� e e EL
Legal Description: 30 35 40 W 138 FT OF E 276 FT OFN 150 FT OF N 1/2 OF SW 1/4 OF SW 1/4 OF NW 1/4(0.48 AC)(OR 4014-566:4018-2106)
Property Tax ID#: 2430-233-0001-400-4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
TEAR OFF EXISTING SHINGLE ROOF AND INSTALL NEW SHINGLE ROOF
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—c ec a appy:
HVAC Ei Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers ElGenerator W1 Roof 412 Roof pitch
Total Sq. Ft of Construction: 1800 SFt.of First Floor:
Cost of Construction:$ 7620 Utilities:Sewer E Septic Building Height: 1 STORY
OWNER/LESSEE: CONTRACTOR:
Name 7le.W'n MQMm Name: I Cb(3 Eds
Address: cx f- Company: ALL AREA ROOFING
City: an State:NY Address: I 'S LLS � I
Zip Code: 14760 Fax: City: -e_ c;e State:FL
Phone No.716-244-2142 Zip Code: 34982 Fax: 772-464-6600
E-Mail: Phone No. 772-464-6800
Fill in fee simple Title Holder on next page(if different E-Mail: JENNIFER@ALLAREAROOFING.COM
from the Owner listed above) State or County License: CCC1326177
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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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.
N n
Signature of Owner/Lessee/CoAr ctor as Agent for Owner Sign a of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCIE COU NTY O F ST LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 28 day of AUGUST 20 1-1 by this 28 day of AUGUST 20 1'7 by
CHARLES RICHARDS CHARLES RICHARDS
Name of person making statement Name of person making statement
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
ignature of Notary Public-State of Florida) Ignature of Notary Public-State of Florida)
o�SLY PBI, FAITH MASON �o4RY Pv�� FAITH MASON
Commission No. r **POIMISSION#GG003939 Commission No. * My(SIZEI�SION#GG 003939
o: EXPIRES:June 20,2020 ?«. \oma EXPIRES:June 20,2020
3�OFF��Q\
Bonded ThruBudget Notary Sarkea OFFtU�' BandedThruBudgetNotarySerW e
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17