HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 a5 Permit Number: \$�`��s�a`
J RECEIVED
Building Permit Application
Planning and Development Services SAN 2 6 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie COu , Permlttlnp
Phone: (772)462-1553 Fax: (772)462-1578 Commercial
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line-RoC •61+�r.
PROPOSED IMPROVEMENT LOCATION:
Address: 5700 Paleo Pines Circle, Ft. Pierce, FL 34951
Legal Description: Holiday Pines SD-Phase I - Lot 33 (Map 13/12N) (Or 474-933)
Property Tax ID#: 1312-500-0034-000-3 Lot No.
Site Plan Name: Block No.
Project Name: Barrett Re-Roof
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove existing roof system down to plywood deck, inspect plywood and nail according to code, dry-
in with IRX peel and stick underlayment, install painted galvanized flashings; galvalume vents and lead
pipe flashings, furnish and install Owen's Corning "Duration" Dimensional Shingles.
CONSTRUCTION INFORMATION:
Additional workto a er orme under this permit—check a app y:
❑HVAC Gas Tank Gas Piping Shutters Q Windows/Doors
11 Electric Plumbing HSprinklers Generator Q Roof Roof pitch
Total Sq. Ft of Construction: S S . Ft. of First Floor:
Cost of Construction:$ $15,000.00 utilities-nSewerE]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameHichard W BarrettName: MiChael H black
Address:5700
Paleo Pines Circle Company: Enterprises Roofing & Sheet Meta .
City: Ft. Pierce State:_ Address: n treet
SW
Zip Code: 34951 Fax: City: Vero Beach State:FL
Phone No. 9 Zip Code: 962 Fax: 569-47T1
E-Mail:kbarrett hsps .com Phone No. 562-
Fill
-Fill in fee simple Title Holder on next page(if different E-Mail: mberoo Ing gmai .Com
from the Owner listed above) State or County License: C03249
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 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.
WdW1
Sig ature wner/Lessee/Contractor as Agent for Owner Signatu of Contractor/License Holder
STATE OF FLQI�LDA STATE OF FL DA
COUNTY OF In Ian River County COUNTY OF n Ian River County
The rpoing instr ment was acknowledged efore me The ff�rgoing instr ment was acknowledged before me
this�4 day of January 20�by thiis(�L4f day., Tanuary / ,20_ by
ka�lr kA ot
2 3
Name of pg�son making statement Name of ryQrson making statement
Personally Known P OR Produced Identification Personally Known 1� OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature o a {L t yblic-StaQl�vtttf RFdf%W� R (Signature of Nota
:•' MY COMMISSION R GG 067886 KEVIi�NEUBAUER
Commission 4,: Ev(Pli3ES:Janu*68IP021 '? MY co� GG 067886
Commission No.
gor,ded Thr,Notary Pudic Undervnilers ;.. r� EXPIRES:January 30.2021
Bonded Thru Notary Pudic Undeswrtas
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17