HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q,�
Date: 11/22/2019 Permit Number:
NOV 2 5 2019
Permitting Department
- - Building Permit ApplicafthcieCounty
Planning and Development Services
Building and Code Regulation Division
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: 6114 Alexandria Circle
Property Tax ID#: 3410-503-0320-000-1 Lot No.20
Site Plan Name: Block No. K
Project Name:
DETAILED DESCRIPTION OF WORK:
Reroof shingles to shingles , Peel and Stick 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: 2800 Sq. Ft. of First Floor:
Cost of Construction:$ 10500.00 Utilities: _Sewer _Septic Building Height:
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OWNER/LESSEE: CONTRACTOR:
Namel-inda Hansen-Delmar Name:roland wiley
Address:6114 Alexandria Circle Company:shorelineroofing
City: ft pierce State:_ Address:1973 sw.Glendale st
Zip Code: 34982 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 CCC1331170
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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-SUPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: I 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'l will,in all respects, perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
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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
THY DER OR AN ATTORNEY BEFORE RECORDI G YO T E OF COMMEN ENT."
Signature of Owner/Lessee/ s Agen for Owner Signature of Contractor/License Holder
STATE OF FLORIDA ae STATE OF'FLORIDA
COUNTY OF J7—A CA, COUNTY OF
The forgo' instrument was ac owledged¢efore me The f rgoing instrument was acknowledged efore me
this�ay of 20� y this�ay of 20 by
Rp\D12a� U\3 alp- Rt�1 A
Name of person making statement. Z�N
im oe f person making statement.
Personally Known OR Produced Identification rsonally Known OR Produced Identification_
Type of Identificati Type of Identification
Produced f Produced
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(Signature of Notary Public-S , 11 1 , OPQ
ture of Notary P
ELLEN.VAUGH ;�>aYP� ELLEN VAUGHIV
;jopye% of Florida-Notary ,o B,%
Commission No. ,o �� _ _ F7� q-Notary Public
74� Commission # GG 2Isslon No. o, Commi i n GG 270079
MY..Commission Ex' � MY Commission Expires��e.` er 22, 20
REVIEWS FRONT G SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19