HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED M(� (�Date: PermitNumber: 1' N19
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
PERMIT TYPE: Reroof
PROPOSED IMPROVEMENT LOCATION
Address: 4950 Dunn Rd, Ft. Pierce, FL 34981
Property Tax ID #: 3403-502-0156-300-8
Site Plan Name:
Lot No.
Block No.
Project Name:
DETAILED DESCRIPTION -OF WORK '
Remove shingles and renail plywood. Apply self adhering underlayment, galvanized metal and 30 ft. of ridge vent.
Install dimensional shingles.
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
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Total Sq. Ft of Construction r'�, 0 e-2 aa&
•D
Cost of Construction: S 66)o - ®d
Generator Roof 3/12 Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer- _Septic Building Height: 1
OWNER/LESSEE:
'CONTRACTOR:
NameJohn Kinley
Name: David Packard
Address:4950 Dunn Rd.
Company: Packard Roofing & Waterproofing, Inc.
City: Ft. Pierce FL State: _
Address:2182 NW Reserve Park Trace
Zip Code: 34981 Fax:
City: Port St. Lucie, State: FL
Phone No.772-461-3696
Zip Code: 34986 Fax: 772-468-9978
E-Mail:
Phone No 772-468-3723
E-Maii.ssmith@packardroofing.com
State or County License CCCA1 7517
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
i
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.
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: _ t 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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF 5+.t.,)c-t-R__
STATE OF FL9RIDA
COUNTY OFJt Wu f-
The for .g�ji_�ng instrument was acknowledge before me
this ��''8ay of .�ylu 201 by
i
The forggmg instrument was acknowledged before me
this i5 nay of -Tatht 2019-,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
(Signature of N lflir
oo�;n� ava� •, STEPHANIE P. SMITH
a - Notary Public -S of orlda
Commission No '
' misslonai3� 24
q' moo;:' My Comm. Expires Sep 2, 2021
(Signature of „„ #rflefl�d
o�;s� op& .; STEPHANIE P. SMITH
: a . ^ : Notary Public - State for
Commission :. • ission4GG13�5`24��
:� Po' My Comm. Expires Sep 2, 2021
REVIEWS FRONT
SUPERVISOR
PLANS
VEGETATION
MANGROVE
ZONING
SEATURTLE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19