HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ��� )-
Date: 11/13/2019 Permit Number:
R r
pr -
ED
Building Permit Appli ation
atio
Planning and Development Services NOV 1 3 2019
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 PeQ 1p� Department
r
I
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Re e
JCI EL
PERMITTYPE: Re-Roof
PROPOSED IMPROVEMENT LOCATION:, 7
Address: 7703 Lockwood Rd Ft Pierce,Fl 34951
Property Tax ID#: 1301-603-0192-000-0 Lot No.23
Site Plan Name: Block No. 15
Project Name:
DETAILED DESCRIPTION OF,WORK:
Reroof shingles to Snap-Lock Metal 30#underlayment
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:$ 12000 Utilities: —Sewer —Septic Building Height:
OWNERAESSEE: CONTRACTOR:
NameRaymond Gagnon Name:roland wiley
Address:7703 Lockwood 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 License CCC 1331170
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.
r
SUPPLEMENTAL CONSTRUCThON LIEN LAW INFORMATION N f
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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
DER ORA ORNEY BEFORE RECO RDI R C OF COMMEKEMENT.
Signature of Owner/Lessee/Con -Agent for Owner Sig ature of Contractor/License H
STATE OF FLORID STATE OF FLORID
COUNTY OF COUNTY OF
The f r oing instrument was acknowledged before me The rf [ng instrument w s acknowlecig efore me
this�day of � 20� by thisday of I 20�by
Jow-akD 1A) i 210y
Name of person making statement. Name of person making statement.
Personally Kno OR Produced Identification Personally Known OR Produced Identification
Type of Identifi c5L - cAT--j&- L,
Type of Identific tion
Produced Produced
(Signature oiNotV"r Public-State of Florida) (Signature of Nota y ublic-State of FloridaCommission �P AUDREYB.HU F, ;:to �Py AUDREYB.HU GCommission N :4,•MY COMA4ISSION * *_ 141SSION##GG 817 XPIRES:March 6,2023. ":•. EXPIRES:March 6,2023
-r,•.. ll IC �, ic•...-�
•.;c)F F;°P` Banded hru Notary , OF Fv. Bon d Thru Notary Publir, n nvn ers
REVIEWS ! — 1 G SUPERVISOR PLANS V�� MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19