HomeMy WebLinkAboutBuilding Permit Applicaiton All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (;/� / ,, /� r,p� /,,
Date: 6/3/2019 Permit Number: ` -l.V lS/�y V I (
• JUN ®
• - _� 1015
Building Permit Application Permitting DQ , .
Planning and Development Services St.LLic;2 t6nrtrngnt
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMITTYPE: Re-Roof Shingle Over Shingle
PROPOSED IMPROVEMENT LOCATION:
Address: 6106 Hickory Dr.
Property Tax ID#: 3402-609-0659-000-6 Lot No.17
Site Plan Name: INDIAN RIVER ESTATES-UNIT-08 Block No. 70
Project Name:
DETAILED DESCRIPTION OF WORK:
Contractor agrees to prepare existing roof for the proper application of a shingle over shingle installation.
We will also replace all penetrations, such as vents, pipes, power poles, etc.,with new penetrations.
We will then apply a limited lifetime warranty architectural shingle over the existing roof surface as per code.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping —Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: OSL Sq. Ft.of First Floor:
Cost of Construction:$ LqN l O-0 Utilities: —Sewer _Septi c Building Height:
OWNER/LESSEE: CONTRACTOR:
NameJann Besok Name: William Koch
Address:PO Box 370283 Company: Koch Inc.
City: Key Largo State:_ Address: 1931 Diamond St.
Zip Code: 33037 Fax: City: Port St. Lucie State: FL
Phone No. Zip Code: 34953 Fax:
E-Mail: jannbesok@hotmail.com Phone No 7723709200
Fill in fee simple Title Holder on next page(if different E-Mail kochinc@hotmail.com
from the owner listed above) State or County License CCC1326960
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
I
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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH UR LENDER OR AN ATTORNEY BEFORE RECORDING YO1VR IYOTK;EOF COMMENCEMENT."
Signature of Own r/Lessee/Contractor as Agent for Owner Signature of Contrac r/License Holder
STATE OF FLORI ( ��i� COUNTYOF
STATE OF FLORID /'( �(2
COUNTY OF ��J— l
The forgging instrurpent was acknowledged before me The fo ing instrument was acknowledged before me
this day of 20Lcfby this day of�ALk 6_R 20a by
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
r �/ A I, A�w "UL r a
L.0
(Signature of Notary Public-State of Florida Isi 'riature of Notary Public-State of Florida
UNES
Commission No. , �;; og��S�1 iELENUNES Com sion No. M� Ge$24707
Commission#GG 324707
_ . -*€Ex ares 17,2023 "; o`=Expires kril 17,2023
o,.• TIVUTtq
REVIEWS FRONT PLANS VEGETATION MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 1
i