HomeMy WebLinkAboutBuilding Permit Application ,q
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:�«� �` Permit Numb r: L 1
1.7
UW-0141111_t J DEC 12 �Q19
Building Permit Application ST. Lucie County, permitting
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 APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:"
Address: 17375 Hammock Ln Fort Pierce, FL 34987
Legal Description: HIDDEN ACRES BLK D LOT 8(2.75 AC)(OR 354-1276)
Property Tax ID#: 3211-811-0032-000-0 Lot No.
Site Plan Name: James&Aleta Cummings Block No.
Project Name: James&Aleta Cummings
Setbacks Front Back: Right Side: Left Side:
DETAIGED.DESCRIPTION OF WORK:
Remove existing roof and replace with new Shingle Roof system. Tri-Built Sand(FL16048-R6)
Owens Corning Shingles(FL10674-R15) Lo-OmniRoll Ridge Vent(FL2847-R12)
CONSTRUCTION INFORMATION:
Additional work toe performed under this permit—check a appy:
HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
❑Electric 0 Plumbing Sprinklers Generator W1 Roof 5/12 Roof pitch
Total Sq. Ft of Construction: 36Sgs S Ft. of First Floor:
Cost of Construction:$ 15,000 Utilities:Sewer Septic Building Height: 12Ft
OWN ERAESS'EE: CONTRACTOR:
Name Aleta&James Cummings Name: Dee Keihn
Address:17375 Hammock Ln Company: PDKRoofing.lnc
City: Fort Pierce State:FL Address: 1299 SW Biltmore Street
Zip Code: 34987 Fax: City: Port Saint Lucie State:FL
Phone No.(772)528-0113 Zip Code: 34983 Fax:
E-Mail:Pdkroofing.lnc@gmail.com Phone No. (772)528-0113
Fill in fee simple Title Holder on next page(if different E-Mail: Pdkroofing.lnc@gmail.com
from the Owner listed above) State or County.License: CCC1331408
If value of construction is$2500 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 jobsite
before-Ve first inspection. If you intend to obtain financing, cogg-ul with lender or an attorney before
comr&ncing work recoftling voAr Notice of Commencemellt.
Signature of Owner/ essee/Contractor as Agent for Owner ignature o ontractor/Lic s Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF r,°� I.�=�r ti COUNTY OF S4- G�C�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this g day of 1;,« 20 /'?by this C/ day of /?e 20LTby
l� zc k- tin Qtr_ Vic: 4 �
Name of person ming statement Name of person making statement
Personally Knowny OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
17
Signature c a e o p a) (Signat re ry - t �'Ja)AL INR �°` A4� MY COMMISSION#GG3 �9a1 ` ':� MY COMMISS #GG32.wwCommission R 24,20 Commission R 24,202I)
Bonded through 1st State Insurance Bonded through 1st State Ins
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17