HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED j tt�� �]
Date: Permit Number. l. 0�' V 1
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 APPLICATION FOR: -Roof
'PROPOSED IMPROVEMENT LOCATION:
Address: 3225 Scarlet Tanager Ct. Port Saint Lucie Florida
Legal Description: EAGLE'S RETREAT AT SAVANNA CLUB PHASE 2 (PB 43-21) BLK 58 LOT 16 (OR 2348-1844)
Property Tax ID #: 3424-702-0026-000-4 Lot No.
Site Plan Name: Block No.
Project Name: Blair Caswell
Setbacks Front Back: Right Side: Left Side:
[D7qAILE6,OESCRIPTION OF WORK:
Remove existing roof system and replace fully with a new Asphalt Shingle Roof System
CONSTRUCTION INFORMATION:
Additional workto ej performedunder this permit — c ec
�HVAC L_I Gas Tank Gas Piping
a
apply:
_ Shutters
a Windows/Doors
❑ Electric 0 Plumbing
OSprinklers
E]Generator
E]Roof 3/.12 Roof pitch
Total Sq. Ft of Construction: 25Sgs
S Ft. of First Floor:
Cost of Construction: $ 11,400.00
Utilities: L_J
Sewer
Septic
Building Height: 20Ft
OWNER/LESSEE:
CONTRACTOR:
Name Blair Caswell
Name: Dee Keihn
Address: 3225 Scarlet Tanager Ct
Company: PDKRoofing.lnc
Address: 1299 SW Biltmore Street
City: Port Si Lucie State: FL
Zip Code: ,34952 Fax:
City: Port Saint Lucie State: FL
Phone No. (772)528-0113
Zip Code: 34983 Fax:
E-Mail: Pdkroofing.inc@gmail.com
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 52500 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 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 a first inspecti n. If you intend to obtain financing, suit with lender or an att rney before
com en in work-VrrecordiU your Notice of Commence ent.
Signa ure of Ow er/ Lessee/Contractor as Agent for Owner
Signature of Contra or License Hold
STATE OF FLORIDA
COUNTY OF Si' . L,,.Q,i 2
STATE OF FLORIDA
COUNTY OF S+ • Lu— e
The forgoing instrument was acknowledged before me
this day of 7u l y 20L by
The forgoing instrument was acknowledge before me
this $ gay of J 4 ! 20 IV by
Name of perso aking statement
Name of person g statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced -
Produced
Signature of N ry P - ate o
ALVIN RODRIGUEZ JR.
Commission No. =f Y ' .0 MY COMM GG327319
EXPIRES: APR 24, 2023
c"" Bonded through 1st State Insurance
(Signature of Notary Pu
Commission No.
- a e o n a
VINR DRIGUEZJR.
_°� r �� W COMMI �Q�I GG327319
EXPIREAPR4,2023
CF
Bonded through 1st State Insurance
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SUPERVISOR
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SEA TURTLE
MANGROVE
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DATE
RECEIVED,
DATE
COMPLETED
Rev. 8/2/17