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HomeMy WebLinkAboutWhite Permit Application DEER PARK AVEAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1/17/2019 Permit Number: 1110=0111111111-M _4 W I Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X PERMITTYPE:SHINGLE ROOF PROPOSED, INPR©VEMENT LOCATION: Address: 7703 Deer Park Ave. Fort Pierce FL 34951 Property Tax ID #: 1301-605-0112-000-2 Site Plan Name: Project Name: tear off existing roof, install new underlayment & new shingle roof CONSTRUCTION INFORMATION: Lot No. 15 & 16 Block No. 44 Additional work to be performed under this permit– check all that apply: —Mechanical _ Gas Tank _ Gas Piping , Shutters Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator X Roof Pitch Total Sq. Ft of Construction: 6'W00 Cost of Construction: $11 !0 t) Sq. Ft. of First Floor: Utilities: —Sewer —Septic Building Height: -5 �N OWNER/LESSEE: CONTRACTOR: Name Roger D White Name: Luis Quinones Company: Rhino Roofs & General Construction Corp. Address: 865 S Kings Hwy City: Fort Pierce State: FL Zip Code: 34945 Fax: Phone N0772-446-1139 Address: 7703 Deer Park Ave City: Fort Pierce State: _ Zip Code: 94951 Fax: Phone No. E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E -Mail info@roofsbyrhino.com State or County License CCC1 331472 if value of construction is $2500 or more, a RECORDED Notice of commencement is requires. if value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable Name: Address: City: State: Zip: Phone MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: FEE SIMPLE TITLE BOLDER: _ Not Applicable Name: Address: City: BONDING COMPANY: Not Applicable Name: Address: 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 �r,.r,rv,onrine lernrie nr rornrrlina unur Nntirp of CnmmPnr.PmPnt. Rev. 9/26/18 Signature of Owner/ Lessee/ ac oras ent for Owner Signature of Contractor/License Holder STATE OF FLORIDA (J�G� STATE OF FLORIDA COUNTY OF COUNTY OF - The forgoing instrument was acknowledged before me this Q day of :Jj� N • , 20 )Q by The forgoing instrument was acknowledged before me this day of /�'iVr 201 by LOIS ®l✓� 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 2jAa4�w 4/w L�v (Signature of Notary P ic- e o F o t= otary u t c State of Florida (Signature of Notary Pub l - f Ffaie Stage of Fb�da� De r Flexen Desiree Flexen Commission No. My C040**n GG 240686 B� My commi on GG 240686 Commission No. td� Expird 2022 v*J,dr Expires 07/22/2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 9/26/18