HomeMy WebLinkAboutBuilding permitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/31/2019 Permit Number:
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
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 5212 Fort Pierce Blvd. Fort Pierce, FI. 34951
Legal Description: Lakewood Park Unit 2 Blk 11 Lot 2
Property Tax ID #: 1301-602-0011-000-5
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Tear off existing shingle roof, renail sheathing, install TriBuilt Sand SA FL16048-R6
Install OC Tru -Def Shingles FL10674-R13
CONSTRUCTION INFORMATION:
Additions work to"e ierforme under tFi–s permit
HVAC 11 Gas Tank F]Gas Piping
I11 Electric 1:1 Plumbing Sprinklers
Total Sq. Ft of Construction: 1800
Cost of Construction: $ 8,875.00
aii apply:
_ Shutters
Generator
S.Ft.. of First Floor:
Utilities::] Sewer D Septic
FA
Lot No—
Block No.
QWindows/Doors
EdRoof 2.5/12 Roof pitch
Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Michael ChambersName: Christopher A. Long
Address: 5212 Fort Pierce Blvd. Company: The Roof Authority, Inc.
City: Fort Pierce State: FL Address: 6771 North Old Dixie Hwy.
Zip Code: 34951 Fax: City: Fort Pierce State: FL
Phone No. 772-501-9090 _ Zip Code: 34946 Fax: 772-468-7870
E -Mail: Phone No. 772-468-7870
Fill in fee simple Title Holder on next page ( if different E -Mail: tra1993@gmail.com
from the Owner listed above) State or County License: CCC056933
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:_
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 Countymakes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conict 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
commencing work or recording your Notice of Commencement. fi'-) 4
re of (�w_nelr/ Lessee/Contractor as Agent for Owner J Sig4ture of Contractor/License Holder
STATE OF FLORIDA STAiE-OF'FLORI DA
COUNTY OF S` I Z,1 -ed /c + COUNTY OF 5"/ Z—ad / C
The forgoing instrument was acknowledged before meThe for Ding instrument was acknowledged before me
this_y of r 201 by this day of nyawj 20_j�L by
W* Cr
Name of person making statement
Personally Known OR Produced Identification
Type of Identif'cation
Produced L -Z) L,
Tom+ Ck,r -,�e�w
Name of pers aking state ent
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of hotary Public- State of Florida) (Signature 6f Notary Public- State of Florida )
tPy o Timothy W Sutton
Commission No. 1 � L V-�STATE
tryW Sutton Commission No. C 1 S NOT PUBLIC
NOTARY PUBLIC ST TEdF FLORIDA
C?F FLORIDA ��, $ Comm# GG185982
REVIEWS FRONT F}�I�1NGtxp317VISORI PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW I REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17