HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� Permit Number:A Sol— (102fl
J . - ' RECEIVED
Building Permit Applicatio FEB 0 2 2018
Planning and Development Services
Building and Code Regulation Division ST, Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof �Ikch �s
PROPOSED IMPROVEMENT LOCATION:
Address: 661 Ponytail Ln, Fort Pierce, FL 34982
Legal Description: PALM GROVE S/D BLK E LOT 29(0.12 AC)(OR 1042-756: 1444-1500)
Property Tax ID#: 3410-503-0166-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Reroof- Remove existing roof covering, Dry in with self adhering underlayment and install new asphalt
shingles.
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit—c ec a appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric ❑ Plumbing []Sprinklers L: Generator E] Roof 5 12 Roof pitch
Total Sq. Ft of Construction: 2676 Sq. Ft.of First Floor:
Cost of Construction:$ 11,026 Utilities:0Sewer 0Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Rudi Kroggel Name: Michael Miller
Address:661 Ponytail Ln Company: Trade Winds Roofing, Inc
City: Fort Pierce State:FL Address: P.O Box 13208
Zip Code: 34982 Fax: City: Fort Pierce State:FL
Phone No.772-579-0512 Zip Code: 34979 Fax: 772-466-9725
E-Mail: Phone No. 772-466-9420
Fill in fee simple Title Holder on next page( if different E-Mail: Mike@tradewindsroofing.com
from the Owner listed above) State or County License: CC C057399
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, consultith lender or an attorney before
commenjcing Workjor recordipg your Notice of Commencement.
Signature of O er/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORJJUA STATE OF FLORIW \
COUNTY OF ,( �C'` COUNTY OF TWCAZ
The forgoing instrument was acknowledged before me The forgoing instrpment was acknowledge ?efore me
thisday of Y 20 l gby this day of 20 Laby
mch(u� MAU N\ �0ha o " kWl
Name of person m king statement Name of persorymaking statement
Personally Known� OR Produced Identification Personally Known Z/ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Pudic-SUA of Florida ) ( gnature of Notary Public ate of Florida
Felicia Lyne Wilkin, R Fencia�yne Wilkin
Commission No. ` A NO-MR41PUBLIC Commission No. SOA �PF OIC
_STATE OF FLORIW L
W ` RIDA
Comm#GG10386t) Comm#GG103860
Expires
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17