HomeMy WebLinkAboutPermit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
- !J
•
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
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 369 Hosbine Street, Fort Pierce, FL
Legal Description: REPLAT OF PALM GARDENS ELK 10 LOT 4 (0.17 AC) (OR 3498-1128; 3501-573)
Property Tax ID #: 3403-802-0117-000-1
Site Plan Name: Jhonathan Osorio
Project Name: Jhonathan Osorio
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Remove existing roof system and replace with 5V Metal Roofing system
5V(14645.2) TriBuiIt Smooth(16048.1)
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Aclaffional work to [eee orme under this permit — c ec a apply:
�HVAC Gas Tank Gas Piping _ Shutters Windows/Doors
Electric ❑ Plumbing Li Sprinklers Generator Roof 1112 Roof pitch
Total Sq. Ft of Construction: 1200
Cost of Construction: $ 6400
S Ft. of First Floor: _
Utilities; Sewer Septic
Building Height: 12ft
OWNER/LESSEE:
CONTRACTOR:
Name Savanna Concierge LLC
Name: Dee Keihn
Company: PDKRoofing.lnc
Address: 369 Hosbine Street
City: Fort Pierce State: FL
Address: 1299 SW Biltmore Street
Zip Code: 34982 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
E-Mail: PDKRoofing.lnc@gmail.com
Fill in fee simple Title Holder on next page ( if different
State or County License: CCC1331408
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable j MORTGAGE COMPANY
Name:_
Address:
City:
Zip:
Phon
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
State
Not Applicable
Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
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 confiict 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, co ult with lender organ attorney before
comm�ir�g work or,recordinR )vour Notice of Commencemeracf. �, / I !
Signature of Owner/ essee/Contractor as Agent for Owner
i ure of Contra c r/ icense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF "r . tr _ .1 ;
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of , 20 'v,� by
this _L�__ day of At]u1.m 20 L- by
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signs re of Notary Public- lorida }
(Signature f Notary Public- State o lorida
Commission No. .?,' (SeAjEXANDERAG5I g
C mission No. IC
;i MY COAlMISSION # GG 2348
1 ALFJfIWI)ER AGUIRRE
'
h:�( 2022
� RES. July 4
'
: MY COMMISSI
ON # GG 23481CXqKMXJWy4
2 �ih
MZ...
,
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
REVIEW
REVIEW
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17