HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Yle&-c-r Permit Number:RECEIV D
' NOV 12 2019
- . Building Permit Applic tion
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie Count FL
2300 Virginia Avenue, Fort Pierce FL 34982 County
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMITTYPE: Residential Roof
PROPOSED IMPROVEME.NT,LOCATION
Address: 4301 Edwards Road Fort Pierce, Florida 34981
Property Tax ID#: 2430-141-0001-000-8 Lot No.
Site Plan Name: Block No.
Project Name: Randy Macadie
DETAILED DESCRIPTION QF WORK
5... . ;. F
Remove existing roof covering, renail deck, install self adhered underlayment and install 24-gauge 5-V crimp metal roof
CQNSTRUCTION IN' FORMATION. '
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 4/12 Pitch
Total Sq. Ft of Construction: 4,000 Sq. Ft. of First Floor:
Cost of Construction:$ 22,783 Utilities: —Sewer —Septic Building Height: 8'
01NNER%LESSEE C.ONTRACTOR:�'
Name _/�N�� `,A C, A d,e Name: Brian Korth
Address: 41*301 ��'w�+r�'r /2�.� Company:FL Contract Services, LLC
city: r.r � 7,`erc e: State: Address: 1080 Loring Drive Suite H
Zip Code: �y�'� Fax: City: Merritt Island State: FL
Phone No. Zip Code: 34953 Fax:-
E-Mail: Phone No 800-327-1982
Fill in fee simple Title Holder on next page (if different E-Mail bckorth2525@aol.com
from the Owner listed above) State or County License CCC 1331576
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 INFORIVIAThON �� _ N
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 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 STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instru ent was acknowledged before me The for oing instrument was acknowledged before me
this day of 20� by this�day of J 20J4 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Versonally Known /IC_ OR Produced Identificati CIO 11N
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Type of Identification J y e of Identification Q o o N
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Commission No Q'i-1051 (Seal) o Commission No. uC'1 U10� I (Seal) �����•.�
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COUNTER REVIEW E d �:= REVIEW REVIEW REVIEW E
DATE
RECEIVED
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