HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 3 -i�.Q t
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Building Permifp0lication
Planning and Development Services Permitting Department
Building and Code Regulation Division St. LUCie Coo htY. FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 301 NE Prima Vista Blvd, Port St. Lucie, FL, USA
Legal Description: RIVER PARK-UNIT 4 BLK 39 LOTS 33, 34 AND 35 (MAP 34/28N)
Property Tax ID#: 3419-530-0219-000-1 Lot No.
Site Plan Name: Block No.
Project Name: KB Port St Lucie LLC
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
TPO Versico Roofing Systems, Recover existing Flat roof(FL14207-R21)
CONSTRUCTION INFORMATION:
Additional work to be ertormed
. under t ispermit—check all h appy:
❑HVAC Gas Tank Gas Piping Shutters Windows/Doors
[:Ip g ❑
11 Electric 0 Plumbing Sprinklers Generator W1 Roof 0/12 Roof pitch
Total Sq. Ft of Construction: 8600 S Ft. of First Floor:
Cost of Construction:$ 40,000 Utilities:Sewer F—]Septic Building Height: 20ft
OWN ER/LESSEE: CONTRACTOR:
Name KB Port St Lucie LLC Name: Dee Keihn
Address:301 NE PRIMA VISTA BLVD Company: PDKRoofing.lnc
City: Port Saint Lucie State:FL Address: 1299 SW Biltmore Street
Zip Code: 34950 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.
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 the first inspection. If you intend to obtain financing,porWIt with lender ora atto ney before
com cin wor r r ordin our ace-of-Commence e .
Signature of Own r Lessee/Contractor as Agent for Owner Signa a of ContraZA
/L'cense Holder
FLORISTATEOF FLORIDA STATE OF
COUNTY OF COUNTY OF
The fpr�o`ng instrument was acknowledged before me The forT ing instrument was acknowledged before me
this ((nn day of_7--c k,'-/ 202C-1 by this (0 Jay of IrNs::� 20_&,by
0
Name of person aking statement Name of person making statement
Personally Known Fe ed Identification Personally Known uced Identification
Type of Identificatio Type of Identification
Produced Produced
1/01i
(Signature o - (Signature o
ALVIN RODRIGUEZ JR. Y P(, AL IN Ruu
115;?•,PU or"'•' -�� MY COMMISSION#GG327319
Commission `� eXpl
SSION#GG32i ®I Commission , p{.&APR 24,202(iSea)
EXPIRES:APR 24,2023
+� OF Bonded through 1st State Insurance
°•.,,°��' Bonded through tst 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