HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �' � =�� Permit Number:
-
Building Permit Applicatior �
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (77 2)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:rer00f
PROPOSED IMPROVEMENT LOCATION:
Address: 6019 Alexandria circle
Property Tax ID#: 3410-503-0177-000-3 Lot No.8
Site Plan Name: Block No. f
Project Name:
DETAILED DESCRIPTION OF WORK:
reroof shingle to shingles peel and stick underlayment
fl 10674-r15 5112 pitch
fl 16048-r6 3000 SF
[CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof 5 Pitch
Total Sq. Ft of Construction: 3000 Sq. Ft. of First Floor:
Cost of Construction:$ 10500 Utilities: —Sewer _Septic Building Height:
OWNERAESSEE: CONTRACTOR:
NameJames Flood Name:roland wiley
Address:6019 Alexandria Circle Company:shoreline roofing
City: ft Pierce State:_ Address:1973 sw Glendale st
Zip Code: 34952 Fax: City: Port st lucie State:fl
Phone No. Zip Code: 34987 Fax:
E-Mail: Phone No772-260-9565 j
Fill in fee simple Title Holder on next page( if different E-Mail shorelineroofing@yahoo.com j
from the owner listed above) State or County LicenseCCC1331170
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INF:ORIUTATIQN
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.
1 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
P95JED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
^1THYVV8kMDERORAkATTORNEY BEFORE RECORDING O TICE OF COM CEMENT."
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Sign ture of Owner/Lessee/Co top
Agent for Owner Signature of Contractor/License of e
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of .20_ by this day of 20_ by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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(Signature of Notary o V (Signature of Notar ate of Florida )
=State of Flor' a No C'HN `�o�u+rP`m,
Commission No. Commg arY Public Commission No. E
''°ilii°• MY Commission GG 270079 •� e ofFF V/�
October 2°� Expires %'',ll %11 Corrlrhi lor;as, UG
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COUNTER REVIEW REVIEW REVIEW REVIEW RE 2 2zR��ll
DATE
RECEIVED
DATE
COMPLETED
iev. 2/7/19