HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: '�\�1 `�� Permit Number:
RECEIVED
Building Permit Application AUG 17 2018
Planning and Development Services
Building and Cade Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residentiai.x
PERMIT APPLICATION FOR: Roof -
PROPOSED-IMPROVEMENT LOCATION.
Address: 5703 birch dr ft pierce fl 34982
Legal Description: indian river estates-unit-08 blk-02 lot-24
Property Tax ID#: 3402 609 0382 000 3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side:, Left Side:
DETAILED DESCRIPTION OF WORK:
reroof shingles to shingles remove exciting roof 30 felt underlayment
CONSTRUCTION INFORMATION:
Additional work toe e orme under tis permit—c ec a appy:
HVAC Ei Gas Tank Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing Sprinklers ElGenerator Roof Roof pitch
Total Sq. Ft of Construction: 1700sf S . Ft.of First Floor:
Cost of Construction:$ 7400 Utilities Sewer[ Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name ginger fernra Name: roland wiley
Address:5703 birch dr Company:.shoreline roofing
City: ft pierce Stater_ Address: 1973 sw Glendale st
Zip Code: 34982 Fax: City: port st lucie State:fl
Phone No. Zip Code: 34987 Fax:
E-Mail: Phone No: 772 260 9565
Fill in fee simple Title Holder on next page(if different E-Mail: shorelineroofing@yahoo.com
from the Owner listed above) State or County License: CCC1331170
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,consult with lender or an attorney before
com or or recording our Notice of Commencement.
Signature of Owner/Lessee/Contracto tA ent for Owner Signature of Contractor/License Hol er
STATE OF FLO41DA STATE OF FLORIDA
COUNTY OF � L���e COUNTY OF S
The forgoing instrument was acknowledge before me The for oing instrument was acknowledged before me
this%A day of 20� by this day of Q-o!!) 20_A by
C)�4,.a,
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced V—L fl L
(Signature of Notary Pu lic-State of Florida) BENS (Signature of NotaFy Publ' - (��(Jt�AM 0022023
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DATE
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Rev.8/2/17