HomeMy WebLinkAboutBuilding Permit Application f
• I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: � v I v-7l'
• RFCF
Building Permit Applications W,? F®.
Planning and Development Services
Building and Code Regulation Division st<c9 oep
2300 Virginia Avenue,Fort Pierce FL 34982 a coo ery�
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resident) X
PERMIT APPLICATION FOR: Roof
PROPOSED iP,ROVEM,ENT LO'CATIQN: _.
Address: 5505 Killarney AVE Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK-UNIT 12-BLK 158 LOT 22 (MAP 13/12S) (OR 4238-2507).
Property Tax ID#: 1301-614-0050-000-7 Lot No.
Site Plan Name: Gregory Hart Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCR'IPTION�(0F WORK: ` 4
i
Remove and replace current roof with new shingle roof system
Owens Corning Shingles(FL10674-R15) 30#(FL12328-R8) Omni Roll Vent(FL2847-R12)
,CONSTRUCT,ION�INFORIVIATIQN: '
Additional work to be erformed under this permit—check all h apply:
HVAC Gas Tank []Gas Piping Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers E Generator W1 Roof 5/12 Roof pitch
Total Sq. Ft of Construction: 2500 Sq. Ft. of First Floor:
Cost of Construction:$ 10,000 Utilities:Sewer OSeptic Building Height: 12ft
OWNER/LESSEE m':' -CONTRACTOR:
_. .
Name Gregory Hart Name: Dee Keihn
Address:5505 Killarney AVE Company:' PDKRoofing.Inc
City: Fort Pierce State:FL. Address: 1299 SW Biltmore Street
Zip Code: 34951 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.
' i
i
SUPPLEMENTALCONSTRUCTION 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 he jobsite
before the first inspection. If ou in nd to obtain financing, c su t with lender or an a torn before
comm4_nin work or recor n o Notice of Commencemen
J
Signature of Owner/L s e/Contractor Agent for Owner Signature o Contractor/L' ense Holder
STATE OF FLORIDA - STATE OF FLORIDA
COUNTY OF 34, COUNTY OF S� Wc.
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 5 day of Mpg+rte. 20 U by this__�_day of ar�
wn20 W by
/
Name of person maKing statement Name of person making statement
Personally Known o_^ OR Produced Identification Personally Known '>r— OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signat of Notary Public-Sta4 of Flo ' a) (Signatu. of Notary Public-StAp of rida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED .....
Rev.8/2/17
AiFXA1Ji)EftAGU1RRE , aZ�n:? ALEXANDERAGUDJI
.,; MY:COl41lNISS10N aGG"23$sllf *; .*_ MY COMMISSION#G
''••,,o;;�;;°`•'. Bonded Ttvu Nolmy PG>ac.Unden _ "%'FoF F;uQ'.Bonded Thru N '
o".Pubk