HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
J -
RECEIVE®
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 IMPROVEMENT LOCATION:
Address: 3112 S 22nd-St Fort Pierce, FL 34982
Legal Description: COL H D GOFORTH S/D BLK 2 LOT 20AND S 20 FT OF LOT 21 (0.29 AC) (OR 3152-2171)-
Property Tax ID#: 2428-602-0045-000-5 Lot No.
Site Plan Name: Robert Richardson Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove existing roof and replace with new Shingle Roof System
Owens Corning Shingles(FL10674-R15) Omni Roll Ridge Vent(FL2847-R12)
Tri-Built Sand Underlayment(FL16048-R6)
CONSTRUCTION INFORMATION:
Additional work to be nprformed under this permit—check all appy:
OHVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors
Electric ❑_Plumbing Sprinklers Generator Roof 3/12 Roof pitch
Total Sq. Ft.of Construction: ' 2 5 S . Ft. of First Floor:
Cost of Construction:$ 11700 Utilities:cn Sewer OSeptic Building Height: 10ft
OWN ER/LESSEE: CONTRACTOR:
Name Robert Richardson Name: Dee Keihn
Address:3112 S 22nd St Company: PDKRoofing.lnc
City: Fort Pierce State:FL Address: 1299 SW Biltmore Street
Zip Code: 34982 Fax: City: Port Saint Lucie State:FL
Phone No.(772)528-0113 Zip Code: 34983 Fax:
E-Mail:PDKRoofing.inc@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 t first inspection. If you in end to obtain financing, co sult with lender or an attor ey before
comm cin work o e rdin t
yoor Notice of Commenceme .
Signature of Owner/ essee/Contracto Agent for Owner gna a of Contractor/,i ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instryment was acknowledged before me The ff oing instrument was acknowledged before me
this 23 day of ` 1 20 d by this May of � ,,'//`ta`� 20_?-C/by
/�� Z �Cr �( !/I � T T vl I; �,h
Name of person king statement Name of person 'ng statement
Personally Known OR Pr srrti€i ation Personally Known OR Pr ed Identification
Type of Identificati n Type of Identification
Produced Produced
(Signature c a (Signature o -bia e o or a
YP
ALVIN RO RIGUEZ JR. tALVIN RODRI UEZJ .
°� U� MY COMMISSION#GG32]
Commissi `35��Oal °f ' � MY COMMISSION#GG3279
Commission d. a I)
RES APR 24,202 S.APR 24,20211
� 0t^ Bonded through 1st State Insurance orn 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