HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED rHq
Date: Permit Number: 0S
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Building Permit Application
Planning and Development Services
Biaiiding"a"rid 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 tMPR01/EMENT LOCAT[OiV �`, �
-Address: 7603 Santa Clara Blvd, Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK-UNIT 7-ELK 71 LOT25 (MAP 13/02N)(OR 3877-13;14)
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Property Tax ID#: 1301-607-0053-000-6 Lot No.25
Site Plan Name: Block No. 71
Project Name: Jennifer Hance's Roof
Setbacks Front Back: Right Side: Left Side:;
.y :x .�,� ,�8r.*gt a3;• f A'.* z ,_ .c-�„k {, r o- x'a'. .wi T k�- s�; . , i 1 3^.,. � �` ,t �§��s,,'- � ;x r , a-.. <
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Replace shingle roof with new dimensional shingles and peel stick underlayment
OR
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Additional work toa er orme un er this permit—check a appy:
1]HVAC F]Gas Tank ❑Gas Piping _Shutters
Elwin'dows/Doors
177, 71
ElElectric ❑ Plumbing Sprinklers E Generator Roof I2 Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
10,500.00 '
Cost of Construction:$ Utilities: Sewer Septic Building Height:
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Name Name: Davin Riedinger
Address: Company: Rock Solid Roofing, Inc.
City: State:FL Address: 1072 Persian Ln
Zip Code: 34951 Fax: City: State:FL
Phone No.772-240-2042 Zip Code: 32958 Fax:
E-Mail: Phone No. 321-749=7069
Fill in fee simple Title Holder on next page(if different E-Mail: rocksolidroofinginc@yahoo.com
from the Owner listed above) State or County License: CCC132.8817
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPfPLf=MEN1�Ak�..CONSTRUCTIO�L��N�LAW �N�OI�MATION � ��� y ������ � �-_ ��.-
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY:!I' X Not Applicable
Name: Name:
Address: Address:
City: State: City: ! State:
Zip: Phone Zip: Rhone:9
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: !;; XNot Applicable
Name: Name: i
Address:1072 Persian Ln 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
I mprovements-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 len or an attorney before
commencing work or recording our Notice of Commencement.
Signature o ner/Lessee ontractor as Agent for Owner Signature tractor/L' ense Holder
STATE OF FLORIDA S TE OFF LORI
COUNTY OF 000-A-3 R-_-v&4- OU
OF �? RSC..
The forgoing instrument was acknowledged before me The forgoing instr as�acknowledged before me
this 22 day of 120 19 by this 22- day of 4:-E!89,uA" 20.18 by
'I N N a-A-G G 4 VI&3 AZ., 2,N)6
Name of person making statement Name of person making statement
Personally Known ✓ OR Produced Identification Personally Known I✓ ORRroduced Identification
Type'of-.Identification, -.Type,of.ldentificationi
Produced Produced
'Pul . ....i
(Signature f Notary P ricin"__�, (Signature f Notary JPublic-State of HOZ
HILDA DE LA HOZ 11' W 001111111111111198101 CF94911'
Commission No.+F 9`F Ir "s MY CC�IfsIF19SION#FF949187 Commission No.y t 9 �b�71' EXl•IREG iabn+ 2020
EXPIRES February 20.2020 1 i Novi +
Ib/)3984153 Ffkawx Nola r yS*Mke.00m
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION j 'SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED'
DATE
COMPLETED
Rev.8/2/17
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