HomeMy WebLinkAboutPermit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/14/17 Permit Number:
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 LIc -1 -P(-I C' fl s2-Y?CY; 7 "HCl ��;i,CC, 9-L g1_Cj, ,
Legal Description: TROPICAL ISLES (OR 2786-2163) UNIT G-19
Property Tax ID #: 3410-508-0172-000-3
Site Plan Name:
Project Name:
Setbacks Front
Back: Right Side: Left Side:
Lot No.
Block No.
JFDETAILED DESCRIPTION OF WORK: I
TEAR OFF EXISTING SHINGLE ROOF AND INSTALL NEW SHINGLE ROOF (MOBILE HOME)
CONSTRUCTION INFORMATION:
Additional work to be pertormed under t ispermit -check all appy:
HVAC Gas Tank ❑Gas Piping _ Shutters Windows/Doors
❑Electric ❑ Plumbing OSprinklers Generator Roof 212 Roof pitch
Total Sq. Ft of Construction: 2500
Cost of Construction: $ 9875
S�Ft.j of First Floor: _
Utilities: L_1 Sewer Septic
Building Height: 1 STORY
OWNER/LESSEE:
CONTRACTOR:
Name' `. +
Address: LA'i
Name: -ems - (c
Company:
Address:
City: it9 r .P,f-C.k- State: FL
Zip CodJ �/ Fax:
Phone No. �� - -� - J �]
�
re:
City: t 't' i ccCs, State:EL
Zip Code: _3y q 8� Fax: 772-464-6600
Phone No. 772-464-6800
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: FAITH@ALLAREAROOFING.COM
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
Name:
MORTGAGE COMPANY: Not Appl icable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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
commexcinR work or recording your Notice of Commencement.
Rev. 8/2/17
S ature of Owner/ Lessee/Contractor as Agent for Owner
Signature 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 li 1-J day of 201 by
this Ll day of 201 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
Pr duce d
Produced
( ture of Notary Public- State of Florida )
(Signature of Notary Public- State of Florida)
"::y ptl'q. FAITH MASON
Y`
Commission No. 5. * My 003939
Y N�Bi` FAITH MASON
Commission No. ` �uMISSION#GG003939
7 `E
?; o� EXPIRES: June 20, 2020
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oe EXPIRES: June 20, 2020
p p oP� Bonded Thru Budget Notary Services
- tion` Bonded'fhru Budget Notary services
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17