HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 19 I I of
Date: 11/13/2019 Permit Number:
CA V
I
NOV 13.2019
_ Building Permit Applica ion
Planning and Development Services Permitting Department
Building and Code Regulation Division Wit. LuCle ®U nty, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE: Re-Roof
PROPOSED IMPROVEMENT LOCATION`.
Address: 6505 Kenwood Rd Ft Pierce,Fl 34951
Property Tax ID#: 1301-612-0410-000-3 Lot No.9
Site Plan Name: Block No. 135
Project Name:
DETAILED DESCRIPTION OF WORK:
Reroof shingles to Snap-Lock Metal 30#underlayment
flat deck 5sq modified to modified with peel and stick base.
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 Pitch
Total Sq. Ft of Construction: 3000 Sq. Ft. of First Floor:
Cost of Construction:$ 17000 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Kathryn Guillette Name:roland wiley
Address:6505 Kenwood Rd Company:shorelineroofing
City: ft pierce State:_ Address:1973 sw Glendale st
Zip Code: 34951 Fax: City: Port st lucie State:fl
Phone No. Zip Code: 34987 Fax:
E-Mail: Phone No772-260-9565
Fill in fee simple Title Holder on next page(if different E-Mail shorelineroofing@yahoo.com
from the Owner listed above) State or County LicenseCCC1331170
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 UEN1.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
ITFF-YOU LENDER OR ANArrORNEY BEFORE RECO RDING-YMR-N TICE OF COMMENCEMENT."
AV
Signature of Owner/Lessee/Contr 's Agent for Owner Signature of Contractor/License
F
STATE OF FLORIDA_4. STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrum nt as acknowledged before me
this day of A) 6 V 20R.by this_&day of 20M•by
f L. jy 00 -r7 An )AL) .may
Name of person making statement. / Name of person making statement.
Personally K n OR Produced Identification ` Personally Known OR Produced Identification
Type of Iden ific n Type of Identification
Produced C, Produced C' L
(Signature of Not#Public-State of Florida (Signature of Notary P c- tate of Florida)
Commission ,•• ermREYBCommission B. Y ` ommsson No.
ori ro t. DiSLP;•i _�UDREY B.�-$��IREY
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Myr #GG 30089 MY COMMISSION#GG 300817
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Bonded Thr'Notary POnded hruNotaryPubticUnrevaticrs :,y,.• •v�;
'•.;�nF FLS.: 'b:it Underwdtors
REVIEWS aT — $IJPERVISOR PLANS VEG "a, RAVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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