HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u t�
Date: Permit Number:
RECEIV7D OCT 18 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 Yes
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: '51 Q LP Q, by- Pt 2I MCC- E.
Legal Description:�Y1f 1�A(�l Y-\Ve"_ I'SAO'Ay s — UL-Vl o— ul
Property Tax ID#: 31+ 2 IJP I b ^ O21 I —COCK ` L Lot No. UJ
Site Plan Name: N/a Block No.
Project Name: N/a
Setbacks Front N/a Back: N/a Right Side: N/a Left Side: N/a
DETAILED DESCRIPTION OF WORK:
We will tear off the existing roofing down to the plywood, Re-nail the deck to the current code and Re-roof.W I
CONSTRUCTION 'INFORMATION:
Additional work to be performed under this permit—check a appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers F]Generator Fv]Roof pt-v 1 41 a_
Total Sq.Ft of Construction: )� $ S . Ft.of First Floor: N/a
Cost of Construction:$ \.P i t-I1 -C7C� Utilities:Sewer ElSeptic Building Height: N/a
OWNER/LESSEE: CONTRACTOR:.
Name lkl Name: Christopher Collins
Address: 7- Company: Collins Roofing Inc
City: Fl� tC Ice_ State:,EL— Address: PO Box 12867
Zip Code: E43 91-1 - Fax:N/a City: Fort Pierce State:FL
Phone No.N/a Zip Code: 34979 Fax: 772-489-6505
E-Mail:N/a Phone No. 772-201-1352 or 772940-8607
Fill in fee simple Title Holder on next page(if different E-Mail: Collinsroofinginc@gmail.com
from the Owner listed above) State or County License: CCC-058011
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: d_Not Applicable MORTGAGE COMPANY: d_Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: d_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 applicati_ exempt from undergoing a full concurren evlewaroom additions,
accessory stru swimmin o s,fences,walls,signs,screen rooms and acce ry uses to ano her non- sidential use
WARFthe
TOO N .Your failure to ecord a Notice of Comme ement may resu your payin twice for
improments to ur property.A N ice of Commencement ust be recor nd posted on a jobsite
bef firs pection. If in nd to obtain financing onsult with d or an attorney efore
co mencin k or r co r Notice of commence ent.
/X � �ZAw�z�
s
LJ5jgAdure"'qf Owner/Lessee/Agent Signa Contr or a er
STATE OF FLORIDA STATE OF FLORIDq� ��G• e
COUNTY OF—,,<+ /� _SC, e- COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this L day of 20 Eby this l E"day of ®ut " ,20 j�by
(Name of person acknowledging) (Name of person acknowledging)
00,7ALK �&4'p C)
(Signature otary Public-State of Florida) (Signature d Not&ry Public-State of Florida)
f �OR Produced Identification
Personally Known•,LL-„ -0R= CATH J l�` Personally Known
Type of Identific�>io pHPQduced
CATHY J ROBERTS6ERTType of Iden 'f
Notary u is-State ��,,,�,�,�„ CATHY J ROBERTS
//° Commission 217013 o�P"�pOA�;�
Commission[Va;•l� lS Commission ,a:ice °�: Notary Public-5� � Florida
p��,- a m.Expir s ar 10,2019 _ Commission FF 22'170B
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°ii 11 Bonded through National Notary Assn. ;�° "o; I�ryy Comm.Expires May 10,2019"
°;;�•�° Bonded through National o ary ss .
Revised 07/15/2014
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DATE
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INITIALS