HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFOMUSTBE CCqMPLETED FOR APPLICATION TO BE ACCEPTED (� l
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Building Permit AP lication NOV - 8 2099
Planning and Development Services
Buildingand Code Regulation Division �,
9 Permitting Depar nye
2300 Virginia Avenue,Fort Pierce FL 34982 O u(� 1=
Phone:(772)462-1553 Fax:(772)462-1578 Commercial ReSberWri Yr
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:_
Address: 609 WILLOWS AVENUE, PORT ST. LUCIE, FLORIDA, 34952
Property Tax ID#: 3419-510-0104-000-0 Lot No. 8
Site Plan Name: RIVER PARK Block No. 13
Project Name: RE-ROOF SHINGLE TO SHINGLE
DETAILED DESCRIPTION OF WORK:
TEAR OFF,AND RE-SHINGLE 2,541 sq ft, OF SHINGLE ROOFING @ 3/12, 1/12, – -f .
30#FELT
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 Zoof 3/12 Pitch
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 12,464.87 Utilities: —Sewer _Septic Building Height:
OW N ERAESSE E: CONTRACTOR:
Name CHARLES W.WYRICK Name: WILLIAM B. EDWARD
Address: 609 WILLOWS AVENUE Company: STORM TEAM CONSTRUCTION
City: PORT ST. LUCIE State: Address: 4050 SOUTH US HWY 1, SUITE 303
Zip Code: 34952 Fax: City: JUPITER State: FL
Phone No. (772) 878-5865 Zip Code: 33477 Fax:
E-mail: cwwyrick49@gmail.com Phone No 561-701-4842
Fill in fee simple Title Holder on next page(if different E-Mail FLPERMITS @STORMTEAMUSA.COM
from the Owner listed above) State or County License CCC1331451
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: _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 YOUR LENDER ORANATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
//.N�� ✓� til//�C".l� � �
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF /1%1#" COUNTY OF At 6 SCacL
The forgoing instrument�was acknowledged before me The forgoing instrument was acknowledged before me
this�day of /Vpl/61 ber,2009 by this—6 day of W V0#"b6r' ,20d by
mil ism a. EvI vil'4 l.S W6111404 8 . resod w'a.Vis
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 Notary Pu c-Stat f F o of Notary P lic-St
Commission No. M Public Stats of FI ida �u�' NRRtary Public State f orida
CUs Kevin Piftman Com sion No. 303 •� $e��Marles Kevin Pittint
My commission GG 303 3 My Commission GG 933
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REVIEWS FRON I OR PLANS VEGETATION
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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