HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l 1'� 1 as Permit Number: 01 ad d aa.�
- >-�,- -<
• RECEIVED
Building Permit Application JAN 14 2020
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia.Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR:. Roof
PROPOSED IMFROVEMENT.LOCATION
Address: 3350 S Jenkins Rd Fort Pierce, FL 34981
Legal Description: 30 35 40 E 128 FT OF W 168 FT OFS 1/2 OF SW 1/4 OF SW 1/4 OF NW
1/4-LESS N 25 FT AND LESS S 158 FT- (49C) (0.44 AC) (OR 340-2296)
Property Tax ID#: 2430-233-0007-000-2 Lot No.
Site Plan Name: Block No.
Project Name: Dixie Jenkins
Setbacks Front Back: Right Side: Left Side:
Y
DETAILED DESCRIPTIONOF'WORK
Remove existing shingle roof and replace with new shingle roof system
Owens Corning Shingles(FL10674-R15), Tri-Built Sand Un erlayment(FL16048-R6),
30# Underlayment(FL12328-R8) Omni Rail Rte, Ri14-(gZ847-KIZ)
CON$TRUCTION IN'FORMATIO`N
Acid itiona work to .e performed under tis permit—check all appy:
❑HVAC Gas Tank ❑Gas Piping in _Shutters a Windows/Doors
Electric F] Plumbing Sprinklers Generator Roof 5/12 Roof pitch
Total Sq. Ft of Construction: 24Sgs S . Ft. of First Floor:
Cost of Construction:$ 9,929.00 Utilities:)Sewer Septic Building Height: 12Ft
0NR/LESSEaE A ". CONTRACTOR:-
Name Dixie Jenkins Name: Dee Keihn
Address:3350 S Jenkins Rd Company: PDKRoofing.lnc
City: FortPierce State:FL Address: 1299 SW Biltmore Street
Zip Code: 34981 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 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 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 Commencementbe recorded and posted on a jobsite
befor he first inspection. If intend to obtain financing, nsu with lender ran ,tor before
com en 'n work o cornour Notice of Commencem
gnature of Owner/ ssee/Contracto Agent for Owner Signature o Contractor/Li a se Ho der
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The for oing instrument was acknowledged before me The fowing instrument was acknowledged before me
this day of 5611, iy 202tl by this `� day of 7 20 Za by
Name of person making statement Name of person ryaking statement
Personally Known ✓ OR Produced Identification Personally Known 6/ OR Produced Identification
Type of Identificatio Type of Identificatio
Produced Produced
(Signature Pub[' ftanda) (Signatur of N - ri a
ALVIN RODRIGUEZ J .
MY COMMISSION#GG327319 o"Y"� MY COMMISSION#G
Commission neo R 24,202oeaI Commission No ? a
t"y. S:APR 24,
Bon
ded through 1st State Insurance
, Bonded through 1st State Insurance
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17