HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE-
I?IFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED '
Date: Permit Number: I
• RECEIVED
Building Permit Application
Planning and Development Services DEC 1 2019
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 5503 Palm Drive., Fort Pierce FL 34982
Legal Description. Indian River Estates-Unit-08 Blk-55 Lot-29
Property Tax ID#: 3402-609-0127-000-8 Lot No.29
Site Plan Name: N/A Block No. 55
Project Name: N/A
Setbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
DETAILED DESCRIPTION OF WORK:
We will tear off the existing shingle roof down to the plywood decking, nail off to the current code and
dry-in the roof using a secondary water-resistant barriar. Install new dimensional asphalt shingles.
;CONSTRUCTION:LNFORMATION ,;, . ,. . . . •„ , • . .
Additional work to be Derformed under this permit—check all that appy:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
1-1 Electric 0 Plumbing OSprinklers Generator Roof 312 Roof pitch
Total Sq. Ft of Construction: 40 Sq Sq. Ft.of First Floor: N/A
Cost of Construction:$ 17,750.00 Utilities:Fl Sewer OSeptic Building Height: N/A
OWNER/LESSEE:. CONTRACT OR.-
Name.Helen M Medeiros Name: ' Christopher Collins
Address:5503 Palm Drive Company: Collins Roofing Inc.
City: Fort Pierce" State:FL Address: P.O.Box 12867
Zip Code: 34982 Fax: N/A City: Ft. Pierce State: FL
Phone No. N/A - Zip Code: 34979 Fax: 772-489-6505
E-Mail: N/A Phone No. 772-201-1352
Fill in fee simple Title Holder on next page(if different E-Mail: collinsroofinginc@gmail.com
from the Owner listed above) State or County License: CCC-058011
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:Helen M Medeiros Name:
Address:5503 Palm Drive.,FartPierce FL34982 Address: 5503 Palm Drive
City: Fort Pierce State: City: Ft.Pierce State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: P.O.Box 12867 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 thepermit 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 wi ,' .all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie unty,A\ endmen
The follow' building "t applica "ons are exempt from undergoing a f concurrenc iew:room add" ions,
access structures imming pools, ences,walls,signs,screen rooms d accesso ses o another non-r sidential use
WIN G T W ER:Your fail a to Record a Notice of Co mencem t may r suit i your pa ing twice for
i pro veme t our property.A Notice of Commence ent mus recor ed d poste on the jobsite
efore th f' i pecti . If yo intend to obtain finan ng, cons with le or an att rney before
comme w rk opolecordin your Notice of Comme cement.
of Own essee Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA `` STATE OF FLORIDA
COUNTY OF O�'i �� Cj e- COUNTY OFThe forgoing ins ument was acknowledged before me The forgoing instr ment was acknowledgVby
efore me
thAas
s L day of 20� by this �ring
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Name of perso making statement Name of person aking statement
Personally Known V OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17