HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
u"r1_15 r t RECEIVED
Building Permit Application Aur ;7 2018
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lu ie County
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address:. 11
Legal Description: Ma raV 1JtA H t5 J 1k C S [(J 14
2_!a CC[ - (e_Sg W 12 �a115+15 �Ot
1�0 1&65 W 12--f4- ( Ana e, Q)�:'
PropertyTax ID f#: Lot No.
Site Plan Name: N/A Block No.
Project Name: N/A
Setbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
DETAILED DESCRIPTION OF WORK:
w c. Vq%X\ -kmy 0-F-C +V-,-
5 A
5A t,.�nd lv�yw.U�v�-�-. 1 5 .,� w 00J4rJ5c_ 51... (,a.
CONSTRUCTION INFORMATION:
Additional work toe nerformed under this permit—clecl all apply:
HVAC Gas Tank E]Gas Piping _Shutters Q Windows/Doors
Electric E]Plumbing .Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: •Zy'Ill S . Ft.of First Floor: N/A
Cost of Construction:$ 15.4 50.00 Utilities: Sewer Septic Building Height: N/A
OWNER/.LESSEE.-,,."
NameC$vrher r_ YlaQds Iru.�'�-1R&Al Name: ,Christopfier Collins
' .Coliins'Roofin Iric.
Address:1�(�ll� Cxt�;IGSi�Q� nr Company: 9 n,
Cty,_��eo;r- n;54p„r State- - Address P O Box"12867 _{
Zip Code: 33160 Fax: N/A City: Ft. Pierce State: FL
Phone No. N/A Zip Code: 34979 Fax: 772-489-6505
E-Mail: N/A Phone No. 772-201-1352
Fill in fee simple Title Holder on next page(if different E-Mail: collinsroofinginc@gmail.com
from the Owner listed above) State or County License: CCC-058011
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: VIP_Not Applicable
Name: Name:
Address: ,.. Address:
City: State: City: Ft.Pierce State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITL',EMOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: P.O.eox I M7 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.
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 permits ns are exempt from undergoing a full"con ncy re ' a s,
accesso ructures,s i ng pools,fe ces,walls,signs,screen rooms and cessory use o other non-resi tial use
W ING TO O R:Your failure o Record a Notice of Com encement ay esu in your paying ice for
[Zefore
provement y ur prope .A otice of Commencer t must be a de and p ted on t e jobsite
the in ection. ou i end to obtain financi g, consult ' len r r attorney efore
comme wo or rpofding y9(ir Notice of Commen ement.
Signa u Owner ssee/Contractor as Agent for Owner ignat e-of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA I
COUNTY OF COUNTY OF
The forgoing instrupent wasacknowledgecl before me The forgoing instru ent was acknowledge before me
this day of 20 b this day of 20by
S
Kaof Jeaking statementI�S Name of pers n making statement
Persona ly now OR Produced Identification Personally Known OR Produced Identification
Type of I entification Type of Identification
Produced Produced
"vl__4—""lt�
(Signatur of (Signatur _ o
�"nr;•., CASEY RENCH ri•�;'•., ASEY FRENCH
6tary Pum� to of Florida `:_Nota ublip_State of Florida
Commission No. • Commission G 167256 Commission o • �'- Cobh#GG 167256
roe.-My Comm.Expires Dec 11,2021 :;�;�+� +doe=My Comm.Expires Dec 11,2021
Bonded through National Notary Assn. ::: `••'' Bonded Through.National NotaryAssn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17