HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u
Date: Permit Number:
' RECEIVE®
, Building Permit Application
Planning and Development Services APR 2019
Building and Code Regulation Division ST. t.EaciQ County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982 -
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof -
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Address: !A-7 H V&V-A-L IN Ccy
Legal Description:
Property Tax ID#: 3414 - 5011 - 1 -701 ^ 000- / Lot No.
Site Plan Name: ff Block No.
Project Name: 60 hr i .0 q.CU tzt f 0 0 F
Setbacks Front Back: Right Side: Left Side:
reD5=zEs nT..A,.�.I-1Er DewE�HS� CRIPcTIO .. _ ri 8. ^.
Complete removal of existing material down to deck, renail to code, instal new self adhered
underlayment and shingle roof �b 1� darn�)
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AdaitionaiworKtol3enerrormeci under this permit-cheCK all that appy:
11HVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers E Generator R1 Roof Roof pitch
Total Sq. Ft of Construction: 3 S . Ft.of First Floor:
Cost of Construction:$ -7, UL O Utilities. Sewer Septic Building Height: f U r
UlttNER/LESSEE' '' CaNTRACTC7R �
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Name V VO4 yi ir44 . 4 cord Name: Ilinunla.q F- Rnt-
Address: J7 Rub/4-p- W Company: Code Red Roofers
City: 100r� A. LV C'ti State: P L Address: 3341 SE Slater St.
Zip Code: Y f S Fax: City: Stuart State:FL
Phone No. Zip Code: 34997 Fax: 772-287-7763
E-Mail: Phone No. 772-287-2829
Fill in fee simple Title Holder on next page(if different E-Mail: iohn@coderedroofers.com
from the Owner listed above) State or County License: CCC1326574
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.
r
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
commencing work or recording our Notice of Commencement.
' ignatu�e of Qwrier. Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLOT?ALV G�� STATE OF FLORIDA
COUNTY OF JJ COUNTY OF /vr Af 1",'0q
The forgoing instrument was acknowledged efore me The forgoing instrum nt was acknowledged before me
this l li day of �� I ,20 �by this 4 day of e" f 201 9 by
Ob.ttd ... f90h1r47 ..0 t3OV/4J R. iZwc
Name of person makinE statement Name of person making statement
Personally Known OR Produced Identification DL Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced F(— Produced
(Signature of ublic-State of Florida) (Signature of ublic-State of Florida)
Commissio Seal Commissi r No. (Seal)
e- P"k-0 JOHN J.SAVAR.ESE
, MY COMMISSION#GG260667
ow,;do EXPI ES:September 20,2U2 J SAVARESE
REVIEWS FRONT PLANS VEGETATION 1 n WX ff"M
COUNTER REVIEW REVIEW REVIEW REVIEW S: epteykW2
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17 -