HomeMy WebLinkAboutBuilding Permit Application I �
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/28/19 O� Permit Number:
RECEIVED
Building Permit Application SEP 18 2019
Planning and Development Services ST, Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential XXX
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: 34 34 39 300 FT of S 2163.5 FT of W 1/2 of E 1/2 of SE
Property Tax ID#: 1334-412-0005-000-9 Lot No.
Site Plan Name: Block No.
Project Name: Montgomery Residence
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Roof- Overlay: Install (1) ply of synthetic underlayment over existing shingle roof, install a 1" standing
seam metal roof system
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check a appy:
1]HVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors
11 Electric 0 Plumbing Sprinklers El Generator 121 Roof 5/12 Roof pitch
Total Sq. Ft of Construction: 3851 S . Ft.of First Floor: 3851
Cost of Construction: $ 12,500 Utilities: Sewer Septic Building Height: 18'
OWNER/LESSEE: CONTRACTOR:
Namel n� Name: gdocd- ab�%%0� 3,
Address n Company: Modern Construction Experts, LLC
Cit : - P State:FL Address: 3141 SE Dominica Ter
Zip Code: 34951 Fax: City: State:FL
Phone No. Zip Code: 34997 Fax:
E-Mail: Phone No. 772-600-7872
Fill in fee simple Title Holder on next page( if different E-Mail: jenni@mcexperts.net
from the Owner listed above) State or County License: CCC1331773
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: ate: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLD . _Not Applicable BONDING COMPA . Not Applicable
Name: Name:
Address:3141 SED nica fer Address:
City: City:
Zip: Phone: Zi Phone:
OWWER/CONTRACTOR AFFIDVIT:Application is hereby ade 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 the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Y
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF COUNTY OF _ U-i'o- ,
The forgoing instrume t was acknowled&g before me The forgoing instrument was acknowledge before me
this CI day of 20 by t�I i day ofiC1� 20 by
e 1.
ame ofp'e7so aking statement Name of person aking statement
sonally Known R Produced Identification ersonally Known^ OR Produced Identification
,TVpe of-IdeatifZc� `Fjpe-of-Ideaificat on-'
.oduced- Produce
ure o (Signatu a of '
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17