HomeMy WebLinkAboutBuilding Permit Application ALL APPLICA E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTER—__---/ ��- -7. to ��.,, �•
Date: Permit umlier:� � ( s z �nf i �
couN- f,.,,...°7N" SEP 2 5 2013
Asemiemenimmeammismis Building Permit Applicat an M ,Yl Dervarinei t
Planning and Development Services ��e !L�l c t iA' F L
Building and 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 IIVIPRQVEMENTLQCATIQN ,: L,
Address: 112 north 39th st 11
Legal Description: wilbuwe blk 2 lot 1 ( 0.22ac) 238-611
Property Tax ID#: 3 c & `0 o_ co) f - o 00 ` q_ Lot No. 1
Site Plan Name: II A, r� Block No. 2
Project Name: VVnn 1 �� w t-
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:„ ° .,
removal and disposal current shingle roof down to plywood. re-nail all plywood decking using 8d rink shank nails to current local code.
include two sheet of plywood replacement. install astm 30#felt underlayment nailed to code. install all accessory metals including but not
limited to:drip edge install new 30yr dimensional shingles. includes installation of new pipes and vents at existing locations.
CONSTRUCTION INFORMATION
Additional work to be performed under this permit–check all;ha apply:
HVAC Gas Tank fI Piping _Shutters [II.Windows/Doors
P g
❑Electric ❑ Plumbing Sprinklers ❑Generator [ Roof 7/ 12 Roof pitch
Total Sq. Ft of Construction: . ,..4.--17, S Ft.of First Floor: 840 sf
Cost of Construction:$ 3,000.00 Utilities: •_Sewer 0 Septic Building •Height: 16 ft
OWNER/LESSEE CONTRACTOR
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NameThomas nicely Name:
Address:112 north 39th st Company:
City: ft pierce State:fl Address:
Zip Code: 34947 Fax: City: State:
Phone No. 772 465 3951 Zip Code: Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
. . ,, a .., ..9 ..
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: —Not Applicable
Name:Thomas nicely Name:
Address:112 north 39th st Address: 112 north 39th st
City: ft pierce State: fl City: State:
Zip: 34947 Phone 772-465-3951 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 o.,-_=•===:_.0. ing, consult with lender or an attorney before
commencing work or recording your Notice •! s 4W11, of cement.
''''..111-4-..:._
Signature of Owner/Lessee/C ctor as Agent fo • .r Signature of Contractor/License Holder
STATE OF FLORID a ETEm,R STATE OF FLORIDA
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COUNTY OF ) ' a iL1,3;g •. COUNTY OF
• v w O S
The f rgoing instru�1ent w s acknowledge.a•,-for_ �.-�T= The forgoing instrument was acknowledged before me
this day of ...-jty,-) • ,20 A by a this day of ,20 by
�(I N
`l 1l V mrA-S N i`e_e t
Name of person making statement Name of person making statement
Personally Known OR Produced Identification f Personally Known OR Produced Identification
Type of I.- .'fication Type of Identification
Produced, . d r „S: (.„ Produced
diF .1 e.g. _
�/
, ....,...ki.t.s .
(Signature of vary Public-State of Florid!) (Signature of Notary Public-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17