HomeMy WebLinkAboutBuilding Permit Application I � _
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED II ^^►
Date: Permit Number:
OMAN
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:LO.CATION ; .
Address: 702 Anita St
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Legal Description: 3 36 FROM NW COR HUNT'S S/D RUN N 330 FT, TH E 940 FT FOR POB,TH CONT E 120 FT,TH S
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170 FT, TH W 120 FT, TH N 170 FT TO POB (29-13) (0.47 AC) (OR 4004-1638)
Property Tax ID#: 3403-331-0002000-7 Lot No.
Site Plan Name: Block No.
Project Name: 702 ANITA-SLC-REROOF
Setbacks Front Back: Right Side: Left Side:
FDETAILED DESCRIPTION:OFV R
TEAR-OFF EXISTING SHINGLE ROOFS DOWN TO PLYWOOD DECK AND INSTALL NEW
ASPHALT SHINGLE ROOFS ON MAIN RESIDENCE
CONSTRUCTION]NFOR'MATION
Additional work to be nertormed under this permit—check all appy:
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0HVAC 11 Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
aElectric 0 Plumbing Sprinklers ElGenerator Roof 412 Roof pitch
;Total Sq. Ft of Construction: 3,600 Sq Ft S . Ft.of First Floor: 2,978
Cost of Construction:$ 12,700.00 Utilities: Sewer E]Septic Building Height: 13 ft
-OWNER/LESSEE CONTRACTOR L
Name Future Capital Financial Corp Name: John F Durham
Address:1817 SW Kimberly Ave Company: Durham Brothers, Inc
City: Port St Lucie State:FL Address: 1371 The 12th Fairway
Zip Code: 34953 Fax: City: Wellington State:FL
Phone No. Zip Code: 33414 Fax: (561) 594-3547
E-Mail: Phone No. (561) 315-1835
Fill in fee simple Title Holder on next page(if different E-Mail:johnfdurham@msn.com
from the Owner listed above) State or County License: CCC 1326757
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:1371 The 12th Fairway 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 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.
Signature"of Ouunec/'Lessee/Contractor as Agenl for Owner Signature of Contractor/License Holdgr
STATE OF FLORIDA STATE OF FLORI
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing Inst umen was!acknowledged before me
this�day of ,u b 2017 by this I I day of Ay 1/ 20-17 by
John F Durham
Name of pers making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of IdentificatiocL
Produced Produced J�
r
n(5I `_`. (Signature f.otw=PubliStatg4of Florida)
�.�•' v KIM M.GUARINO
�B� •Pay P�,,�� KIM M.GUAlilly
Commi iQ * +�, Notary Public State o(f♦ qua Commissio Imo` B`�: NotaryPublic-Slat ida
•+ .•E ommrsslon#FF 900873 Commission #FF 90083
M Comm.Expires Jul 16,2019
oFF�o?;' y p �,?, •�.� My Comm.Expires Jul 16,2019
•4 N• �i�FOF F���
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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