HomeMy WebLinkAboutOrr Permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/13/17 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 — 51-1-tV � Ce_
PROPOSED IMPROVEMENT LOCATION:
Address:Lo�oUV NL.a IC:Ick 0C r_4 1'ii'c(' 1--L-
Legal Description: LAKEWOOD PARK -UNIT 9- BLK 114 LOT 10 (MAP 13/01N) (OR 1626-1389; 3810-617)
Property Tax ID #: 1301-611-0284-000-7 Lot No. 10
Site Plan Name: Block No. 114
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 to fl
r orme un er t is permit— c ec a appy:HVAC Gas Tank 0Gas Piping _ Shutters Windows/Doors
11 Electric ❑ Plumbing Sprinklers a Generator W1 Roof 512 Roof pitch
Total Sq. Ft of Construction: 2600
Cost of Construction: $ 11640
SFt. of First Floor: _
UtiIities:cnSewer Septic
Building Height: 1 STORY
OWNER/LESSEE:
CONTRACTOR:
Name (y (C.a_i k (fir I--
Name: } 1 i �S J (CJ
Address:CoCC0� �k�c� T)t
Company: `R -t (-Y)-
Address: 'p b S `i jwu I
City: i F 1 C C, State: FL
Zip CodLjc'.5) Fax:
Phone No. �._, - C> Ks'%(n
'e:
City: __ gni'e.(_C=C Stater
Zip Code: 3ycjteA 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 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
commuting work or recording your Notice of Commencement.
L
"ofOwner/
S ature 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
/S day 202_� by
this 13 day of 200 by
this of ?Lb L'i ,
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
I—U'4t__�
(Signature of Notary Public- Statgee'f%prida) FAITH MASON
�'•
(Signature of Notary Public- State of Florida )
? � O
MY COMMISSION # GG 003939
#
�y p�
o P „ e9el MASON
Commission No.
IFIQ�ITH
Commission No. * 4� 9AYISSION#GG
��($e_APIRES:June20,2020
9lCOF F�o�� Bonded Thru Budget Notary Services
003939
EXPIRES: June 20, 2020
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OF FloO� Bonded Thru Budget Notary Services
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Rev. 8/2/17