HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
Building Permit Application MAR 21 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982 X
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION`:
Address: 110 N 39th-ST Fort Pierce, FL 34947
Legal Description: WILBUWE BLK 2 ALL LOT 2 AND N 5 FT OF LOT 3 (0.23 AC) (OR 650-2462)
Property Tax ID#: 2408-603-0012-000-6 Lot No.
Site Plan Name: Block No.
Project-Name: Phyllis Carey
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove current asphalt shingle roof and replace it with a new asphalt shingle roof
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy: .
HVAC Ei Gas Tank ❑Gas Piping s ' _Shutters Q Windows/Doors
Electric 0 Plumbing OSprinklers Generator Roof 4 12 Roof pitch
Total Sq. Ft of Construction: 21 S . Ft.of First Floor:
Cost of Construction:$ 10,500.00 UtilitiesSewer Septic Building Height: 16
OWNER/LESSEE`. CONTRACTOR:
Name Phyllis Carey Name: Dee Keihn
Address:110 N 39th ST Company: PdkRoofing.lnc
City: Fort Pierce State:FL Address: 1299 Sw Biltmore Street
Zip Code: 34947 Fax: City: Port Saint Lucie Florida State.FL
Phone No. Zip Code: 34983 Fax:
E-Mail: Phone No. (772)528-0113
Fill in fee simple Title Holder on next page(if different E-Mail: pdkroofing.inc@gmail.com
from the Owner listed above) State or County License: CCC1331408
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 thepermit 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 ' tend to obtain financing, consult with lender or ay orney before
com cin work-or regdrding vokir Notice of Commence t.
Signature of Own r/ essee/Contract ent for Owner r1inature of C tr ctor/License Ho
STATE OF FL RIDA STATE OF FLORIDA
COUNTY OF-- ruc le- COUNTY OF&Q-1 LuGI<--
The r ping instr e t was acknowledged before me The f $ping instrument was acknowledge before me
this day of 20LCA by this� l day of AACtt GV1 20 by
0-e e- � -e e— Ke ""A ,,
Name of person making statement Name of person making statement
Personally Known OR Produced Identification L, Personally Known OR Produced Identification
Type of Identifi ation Type of Identification
Produced — Produced
1�'yY P(,¢� MICHELLE GREEN
C4,' y�` Notary Public State of Florida ;; , MICHELLE GREEN
a� �a`' Commission q GG 286318 `?°;cl��i: Notary Public-State of Florida
'oF F��`' My Comm.Expires Dec 20,2022 '•�" o` Commission r GG 266318
(Signature of Notary Publi e o g a,ona Notary ssn. (Signature of Notary Public- ate '. lo�slmm.Expires Dec Z0,2022
on ed t ough National Notary Assn
Commission No 0 3 $ (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