HomeMy WebLinkAboutBiuilding permit appPlanning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxx
PERMIT TYRE: Roofing
Address: . �
Property Tax ID #: -
Site Plan Name:
Project Name: re -roof
Lot No. G
Block No. ) -
CONSTRUCTION INFORMATION;
Additional work to be performed under this permit– check all that apply:
Mechanical — Gas Tank — Gas Piping ^ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:*,02 ,
Cost of Construction: $ ) o, 11T)
Generator
Sq. Ft. of First Floor:
Utilities: Sewer , Septic
Name
Address: �` Q
City: Ft Pierce FL State:
Zip Code: Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the fawner listed above)
CONTRACTOR:
Name: Richard Newland f
Company: Richie the Roofer
Address: 905 13th st sw
Citv: Veripo Beach
.J;I—Wi ows/ ors
oof �- Pitch
Building Height: (6
Zip Code: 32962 Fax:
Phone No772-473-6197
E -Mail richieroofer@yahoo.com
State or County License 20506
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
if value of HVAC is $7,500 or mare, a RECORDED Notice of Commencement is required.
State: FI
256
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 thepermit 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOT1"F COMMENCEMENT."
Signature of Owner/ Lessee/Contractor a Ag tfor Owner
ignature of Contractor/License Holder
STATE OF FLO SQA
COUNTY OF �_ K -XA t ( .
STATE OF FLO
COUNTY OF G4 '
The f�W_ng instrJent wa acknowledg d before me
thiay of 1✓' t t 2(3_ by
The f r nstr was cknowledge before me
this day of ) 20 y
Name of person making statement.
Name of person &aking statement_
Personally KnownR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
t 44 Notary Public State of Fiorida 4.
r . `�, —Amanda i$ S n GG 211 c
+ My Cammis- - GG 21425
Produced
{ 11
�—
(Signature of Nofar is tate o
Pugic State
manda'P Sanderson
Commission No. r e�d) My Commission GG
M1� ExQires 04!2512022
at of Nota Public- State o
F{e (� ry
D,t r Notary Public State f
ld8mmis n No. �. ell} Amanda P Sanders
y My Commission G 2
�cr ExpireS O4125I2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
256