HomeMy WebLinkAboutBuilding permit app j
i
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: @00c-( —ost2
i w
Building Permit Application
Planning 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 X
PERMITTYPE: ROOFING
PROPOSED IMRROVEMENT LOGATIQN f w ,°
Address: 5213 HICKORY DR, FORT PIERCE, 34982
Property Tax ID#: 3402-608-0431-000-9 Lot No. 37 I
Site Plan Name: INDIAN RIVER ESTATESBlock No. 511
Project Name:
DETAILED DESCRIPTION OF.WORK
REMOVE EXISTING 3-TAB SHINGLE ROOF. INSTALL SELF ADHERING UNDERLAYMENT OVER ENTIRE RC
INSTALL NEW 26 GA 5V METAL ROOF.
I .
I
CONSTRUCTION INFORMATION:,;. +.. l
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 4:12 Pitch
Total Sq. Ft of Construction: 2300 Sq. Ft. of First Floor: 2300
Cost of Construction: $ 4625.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE` °CONTRACTOR: '
Name RICHARD MOORE QUINN Name:
Address:5213 HICKORY DR Company:
City: FORT PIERCE State:_ Address:
Zip Code: 34982 Fax: City: State:
Phone No.615-454-7934 Zip Code: Fax:
E-Mail:RICK-QUINN@COMCAST.NET Phone No
Fill in fee simple Title Holder on next page (if different E-Mail
from the Owner listed above) State or County License
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.
'1
8U3PPL°EMENTAL_:CONSTRIJCTION ,LIEN LAW INFORMATION
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Ap'plicalle
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:
it
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 followingbuilding g 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 &kTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
r
Signature of Owner/Lessee/Con actor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA 1 STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument w s acknowledged before me The forgoing instrument was acknowledged before me
this day of ' 202Q by this day of 20_ by
Name of person making statement. Name of person making statement.
Personally Known X OF Prod;' d Iden ' E a sonally Known OR Produced Identification
Type of Identification = T e of Identification j
Produced '-MY COMMISSION#GG09 4� duced
•,�y,����. EXPIRES April 08,2Q2
i
(Sig ature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida )
Commission No.a&109I101 (Seal) Commission No. (Seal)
i
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19
j