HomeMy WebLinkAboutPermit app ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/6/17 Permit Number:
•
W
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 --, 1�- L'c
PROPOSED IMPROVEMENT LOC TION:
Address:
Legal Description: GOLDEN PONDS- 1664 WALDEN POND DR FT PIERCE, FL 34945
Property Tax ID#: 2303-211-0025-000-5 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 (MOBILE HOME)
CONSTRUCTION INFORMATION:
Additional work to a er orme under this permit—check a apply:
HVAC E]Gas Tank Gas Piping _Shutters ❑Windows/Doors
O
Electric ❑ Plumbing ❑Sprinklers E Generator Z Roof 3�12 Roof pitch
Total Sq. Ft of Construction: 1700 S Ft. of First Floor:
Cost of Construction:$ 6650 Utilities:n Sewer OSeptic Building Height: 1 STORY
OWN ER/LESSEE: CONTRACTOR:
Name kytiX'_`� 1O_GCIi tO Name: 1� 1-c_ I\, C l ."_ s
Address Company: - '`V W
City: Aot\ j j g State:FL Address: _3c L4) 5 US t i W
Zip Code: ) Ulo GJ Fax: City: i ,cc( r
77�. State
Phone No. `� I ;>,��) �'��`� Zip Code: j L{�}Z�( Fax: 772-464-6600
E-Mail: Phone No. 772-464-6800
Fill in fee simple Title Holder on next page(if different E-Mail: FAITH@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
commenSing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signatu e of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCIE COUNTY OF ST LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 6 day of DECEMBER 20 1 J by this 6 day of DECEMBER ZOO 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
(Signature of Notary Public-State of Florida ) ( i ature of Notary Public-State of Florida)
�cry Pus AITH MASON ZgnY Pu��ic tom,,�.`F,AITH MASON
��` #6 6r t ISSION#GG 003939
Commission No. I Commission No. ,:.• M
P ISSION#GG 003939
?' ?1 Q EXPIRES:June 20,2020 `pt°' `oe EXPIRES:June 20,2020
„-Fjrj';o Bonded Thru Budget Notary Services OF F Bonded Thru Budget Notary Services
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17