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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: ©©5•o3aa' • FIX Building Permit-Application ,Planning and Development Services Building and Code Regulation Division 12300 Virginia'Avenue,Fort Pierce FL 34982 1 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X PERMIT APPLICATION FOR: -Roof 4 PR®FOSE© 1MPVROVEM'E'NT LOCATION #': °� � . - - A,ddress: 405.SE Airoso BLVD Port St Lucie, FL 34983 Illegal Description: RIVER PARK-UNIT 6-BLK 57 LOT 5 (MAP 34128S) Property Tax ID#: 3419-545-0023-000-6 Lot No. Site Plan Name: Henry Cayton, Block No. _ Project Name: Hen. rY Ca Yton ISetbacks Front Back: Right Side: Left Side: 'ETAIILE® DESC,�RI�PTI��,NOFWgO�RK� �'Y'��,�'.�_�� � ��,���°" *'` r.� ._• � �.�..�� ��. ��-� �� �. ,: Remove existing roof system and replace with new Shingle Roof System: Owens Corning Shingles(FL10674-R15) TriBuilt Sand(FL16048-R6) OmniRoll Ridge Vent(FL2847-R12) CON�STRU�CC"fl' N�IN`F®'R11/IATIO,IV¢= �� . h t Additionalworl to e e orme under this permit—c ec a apply: O HVAC L__I Gas Tank ❑Gas Piping Shutters. Q Windows/Doors Electric 0 Plumbing Sprinklers Generator Roof 3/12 Roof pitch Total Sq. Ft of Construction: 1300 S . Ft.of First Floor: Cost of Construction:$ 6000 Utilities:Sewer F_Septic Building Height: 12ft®WNER/LESSE� HenryxCayton - ; CONTRACTOR PDKRoofing-lnc, Name Henry Cayton Name: Dee Keihn Address:405 SE Airoso BLVD Company: PDKRoofing.lnc City: Port St Lucie State:FL Address: 1299 SW Biltmore Street Zip Code: 34983 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. j 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: rZip: 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 I n 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 a first inspectio . If yo intend to obtain financing, co with lender o5O att rney before com entin work re ordin our Notice of Commenceme Signatu of Owner/Le see/Contractor as Agent for Owner Signature of Contract r/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrumen�j as acknowledged before me The forgoing instrum t was acknowledged before me this t�day of /���cl 20�by thisL_�ay of /r/—e c A 20`C/by !� Ir Name of person m g stat Name of person maki atement Personally Known 0 oduced Iden ication Personally Known R Produced Identification Type of Identification Type of Identification Produced Produced 0/,e ignature of Not of (Signature of Notary P - AWN RODRIGUEZJR. AL V V RODRIGUEZ;JR. Commission No. r°`�Y"� MYCOMMI )#GG327319 Commission No. Y'� EXPIRES:APR 24,2023 Y COMMISa6327319 EXPIRES:APR 24,2023 Bonded through 1st State Insurance O Bonded through1st 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