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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1��� �`� Permit Number: k0\1\-00rJy
RECEIVED
Building Permit Applicati n Noel n 4 ,p,
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential .x
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 12065 S Indian River Dr.Jensen Beach, FL 34957 --
Y Property Tax ID#. 4504=602=0007=000=6- _ — - - - Lot No.7&8------
Site
Site Plan Name: Block No.
Project Name: Veatch Re-Roof
DETAILED DESCRIPTION OF WORK:
FRS will tear off existing shingle roof down to plywood. FRS will re-nail plywood with 8d ring shank nails. FRS will install
Polyglass Polystick MTS self-adhered undedayment. FRS will install 3x3 drip edge attached to code. FRS will install 24
gauge 1"nailstrip standing seam metal roof system to 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 5/12 Pitch
Total Sq. Ft of Construction: 1 1d C1 Sq. Ft.of First Floor:
Cost of Construction-$ s7-o, Qyo, � Utilities: _Sewer _Septic Building Height: 20'
OWNER/LESSEE: CONTRACTOR:
NameTerry P Veatch Charlene B Veatch Name:David Capps
Address:12065 S Indian River Dr Company.-Florida Roofing Services
City: Jensen Beach, FL State:_ Address:8470 SE Dharlys St.
Zip Code: 34957 Fax: City: Hobe Sound, FL State:
Phone No. Zip Code: 33455 Fax:
E-Mail: Phone No561-427-9286
Fill in fee simple Title Holder on next page(if different E-Mailflorida.roofing.services@gmaii.com
from the Owner listed above) State or County License CCC1 328967
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.
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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 thepermit 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/Co rk
ractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF!SM U V,16 COUNTY OF cy)
The forgoing instr yen wits acknowledged before me The forgoing instrument was a cnowledged before me
this 9 day of t_Y 20]1 by this day of 0 20ti� by
Name of pe son making statement. Name of person making st a ent.
Personally Known l`� OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Producedced
DIANE COLE
v Pue��'- NotaryPublic-$Cate of Florida
•_ Commission#FP97 317
L :t5�ynjti(Signature of Notary Public-Stat a ; .R ,9ondedthrough National No re of Notary Public-StaG �Z>la) D I LLE CARNEY
?@M Nota is-State of Flori a
cp p�mission#GG 358920
Commission No (Seal) Commission No. �C� ✓ oFF°�'�� Q m.Expires Jul 24,20 Z3
Bonded through National Notary Assn
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