HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 019 Permit Number: ava v1_ O'Y&7.
RIEW C19 E
IV E D
Building Permit Applic 3tion
Planning and Development services JAN 2 7 2020
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Permitting Department
Phone: (772)462-1553 Fax: (772)462-1578 Commercial R esint�i�C�y, FL
PERMITTYPE: Re-Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 430 Banana Lane
Property Tax ID#: 3410-503-0292-000-5 Lot No.40
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Reroof shingles to shingles Peel And Stick Underlayment
CONSTRUCTION INFORMATION:
I Additional work to be performed under this permit—check all that apply:
Mechanical Cas Tank Gas Pining Shutters \A/inwlp;;ic/nCnrs
Electric Plumbing _Sprinklers Generator Roof 5 Pitch
Total Sq. Ft of Construction: 3000 Sq. Ft.of First Floor:
rnct of n str ctin • 1 10500 Utilities: Sewer Santir Riiilrlina Height II
OWNERAESSEE: CONTRACTOR:
Name Judy Cross Name:roland wiley
Address:430 Banana Lane Company:shorelineroofing
ICity: ft pierce State:_ Address:1973 sw Glendale st I
ZiD Code: 34982 Fax: Citv: port st lucie State:fl
Phone No. Zip Code: 34987 Fax:
E-Mail: Phone No772-260-9565
Fill in fee simple Title Holder on next page(if different E-Mail shorelineroofing@yahoo.com
from the Owner listed above) State or County License CCC1331170
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If..b....^.f:-I:l.A-.r.:°.$7,rnn —are,a RECORDED Not:c--of Commencement;-... required.
SUPPLEMENTAL CC►NSTRUCTION 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 TITLEHOLDER: _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 fol lnwing.build Ing.Permit appliCati.ans are exP_n'rat from,wndP_lgoi!?g 3 f-di-cr1ncurrenvy re_ula%c.room.ad-c itjrins,-
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
E R OR AN ATTORWY BEFORE RECORDNNG Y NOT COMME CEME "
LJ\ Dr
1
Signature of Owner/Lessee/Contractor as A t f r Owner Signature of Contractor/License Holder
STATE OF FLORIDA I STATE OF FLOR .,
COUNTY OF COUNTY OF
The for oing instrument was acknowledged before me The forgoing instru was acknowledge efore me
this:day of 20:2V by this 42zday of 20_ by
Name of person making statement. Name of person making statement.
Personal) nown OR Produced Identification Personally KnownOR Produced Identification
Type of dent) ' tion Type of Identi icatio
Produced �� Produced
(.,16nar,.., .,����., ���lp `IHR (Signatuie of NO iy ruullC-Stara O
M1(COMMISStON#GG 300617
B.HUMPHREY
Commission N =*: �'= IRES:M Commission No. ':+?;: AUDRIcY 17
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sonde 7hN ll�t�Y�Lfic Undervt�lM i;• ;t: 6.2tJ23
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Undeiwdters
REVIEWS FRONT ZONING SUPERVISOR PLANS V E G SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEI V EC
DATE
COMPLETED
Rev.