HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BECOMPLETEDFOR APPLICATION TO BE ACCEPTED .
Date: I -1'2b Permit Number:-� O Ll_Z
RECEIVE
Building Permit Application
Planning and Development services FEB 19 2020
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: 801 Ulrich Rd Fort Pierce, FL 34982
Legal Description: ULRICH'S S/D BLK C LOTS 6, 7, 8 AND 9 AND W 25 FT OF LOT 10 (0.75 AC) (OR 1638-2691)',
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Property Tax ID#: 3410-603-0072-000-4 Lot No.6,7,81,9
Site Plan Name: Block No. C '.
Project Name: Roop - Flat Re-Roof
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove and replace flat portion of roof covering
Polyglass Modified Bitumen : FL1654-R24
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CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all that appy:
HVAC Gas Tank Gas Piping ElShutters Windows/Doors
Electric ❑_Plumbing Sprinklers Generator Roof 0.125 Roof pitch
Total Sq. Ft of Construction: �;�oG S . Ft.of First Floor: 66C
Cost of Construction:$ 6,000 Utilities:Sewer Eheptic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameThomas Roop Name: LARRY NEESE
Address:801 Ulrich Rd Company: LARRY NEESE, LLC
city: Fort Pierce state:FL Address: 3401 S. US HWY 1
Zip Code: 34982 Fax: City: FORT PIERCE State:FL.
Phone No. Zip Code: 34982 Fax: 772-361-6581,
E-Mail: Phone No. 772-361-6580
Fill in fee simple Title Holder on next page(if different E-Mail: larryneeseroofing@gmail.com
from the Owner listed above) State or County License: CCC1330608
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: XX 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. I'
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. County Amendments.
The following building permit applications are exempt from and Ing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs een rooms and accessory uses to another non-reside use
WARNING TO OWNER: Your failure KNotice
a Notice of Commencement may result in your ing twice for
improvements to perty.A NCommencement rn a del and p ed on the jobsite
before the Inspectio If you intbtain financing, suit with nder ora attorney before
Comm cin work or Cor
youof Commence ent.
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Signature Owner/Lessee/Contr ctor as Agent for Owner Signature Contractor/License Hol er
STAT OF FLORIDA STATE FLOR
COU Y OF COUNTY OF
The fo oing instrument as acknowledged before me The f oing instruCajent was acknowledged before me
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this day of e. 20.E )by this day of �� 20J by
Larry ncrP_,y,--P,
Name of per on making statement Name of p son making statement
Personally Known�OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produce Produce
(Signature of No Pub - f FI4tJ*4ublic'State of Florida (Signature of No r i
Amy N Wood �te ry Public State of Floridi
Commission No. , MY )asion GG 241645 Commission No �rny N W al)_
Expires 07/25!2022 MY Commit stotl c�241846
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Expires 07/2512022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17