HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ti`ay �aa Permit Number: ad d f.d 5aa
RECEIIPermittIng
ip Building Permit Application JAN 2
Planning and Development Services
Building and Code Regulation Division sT. Lucie Coun
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: 840 SWAiroso Blvd, Port St. Lucie, FL, USA
Legal Description: RIVER PARK-UNIT 6- BLK 60 LOT 4 (MAP 34/28S)
Property Tax ID#: 3419-545-0072-000-4 Lot No.
Site Plan Name: Block No.
Project Name: Elizabeth Vargas
Setbacks Front Back: Right Side: - Left Side:
DETAILED DESCRIPTION OF WORK:
Remove Flat roof system and replace with new Polyglass SBS and APP Modified Bitumen,Roof
Systems (FL1654-R23)
SBS Membranes: Elastoflex SA V Base & Elastoflex SA P
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy:
HVAC []Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing O Sprinklers Generator Roof 0/12 Roof pitch
Total Sq. Ft of Construction: 3Sgs Sq. Ft.of First Floor:
Cost of Construction:$ 3,400.00 Utilities: Sewer E]Septic Building Height: 1017t
OWNERAESSEE: CONTRACTOR:
Name Elizabeth Vargas Name: Dee Keihn
Address:840 SW Airoso BLVD Company: PDKRoofing.lnc
City: Port St. Lucie State:FL Address: 1299 SW Biltmore Street
Zip Code: 34983 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 an posted on the jobsite
before the first inspection. Ifyou intend to obtain financing suit with lend r or n attorney before
com c n work r cor our Notice of Commence nt
Za
Signature of Own r Lessee/Contractor as Agent for Owner Signature of Co tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The for oing instru t was acknowledged before me The forgoing instrpTent was acknowledged before me
this-4 day of J )Lr_,20`V by this L day of 20_c LCby
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Prod d ntification
Type of Identifica ion Type of Identificatio
Produced Produced
(Signature (Signature
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Al VIN IGUEZ JR. ALVINR UEZJR.
�y yB o:... ...
Commissio �o �� MY ISSION#GG3274-0� I) Commission �. :� ISSION#GG327� I�
EXPIRES:APR 24,2023 R 24,2G2�
IRV Bonded through 1st State Insurance � zona®d through 18tSietetnsurance
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17