HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
-_J I J
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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: 1103 N 37th ST Fort Pierce, FL 34947
Legal Description: PLAT 2-SUNLAND GARDENS BLK 33 LOTS 13 AND 14 (0.25 AC) (OR 1906-2015)
Property Tax ID #: 2405-703-0012-000-4
Site Plan Name: Romona Holmes
Project Name: Romona Holmes
Setbacks Front Back:
I DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Lot No.
Block No.
Remove existing flat roof and replace with new Modified Bitumen Roof System (FL1654.1)
CONSTRUCTION INFORMATION:
Aciclitional work to be ertormed under tispermit — check all th appy:
HVAC Gas Tank Gas Piping Shutters F]Windows/Doors
11 Electric Plumbing Sprinklers Generator Roof Of12 Roof pitch
Total Sq. Ft of Construction: 600
Cost of Construction: $ 4,800.00
SFt. of First Floor: _
Utilities:Sewer Septic
Building Height: 12ft
OWNER/LESSEE:
CONTRACTOR:
Name Romona Holmes
Name: Dee Keihn
Address: 1103 N 37th ST
Company: PDKRoofing.lnc
City: Fort Pierce State: FL
Zip Code: 34947 Fax:
Phone No. (772)528-0113
Address: 1299 SW Biltmore Street
City: Port Saint Lucie State: FL
Zip Code: 34983 Fax:
Phone No. (772)528-0113
E -Mail: PDKRoofing.lnc@gmaii.com
E -Mail: PDKRoofing.lnc@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: CCC1331408
11 value ur cunsirucuon is u3uu or more, a KtcUKutu Notice oT commencement Ls required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
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 poois, 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 CommencementLon
st be recorded and 'sed on the jobsite
before the first ins ecti n. If Jou intend to obtain financing, s with le er an a lrorney before
com ncng wor}or IordirR your Notice of Commenc/
Signature of OwnV1 Eessee%Contras as Agent for Owner I Signature of Contr ctor/License Hol
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 9- L.j� e COUNTY OF i5i—. . L—Lui c
The forgoing instrum nt was acknowledged before me
his �`'�
tday of ' (1 l 20_2�Dby
OL h n
Name of person making statement
Personally Known < OR Produced Identification
Type of Identification
Produced
(Signage of Notary Public- Sta(a of Fl rids )
Commission No.
W COMW$SION 0 GG 231811
li»
REVIEWS
COUNTER I REVIEW I REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. $/2/17
The fo oing instrument was acknowledged before me
his
tj � day of Ckkl 203D by
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
4�� 5h_c
{Signature f otary Public- Stat orida )
Commission N
ALEXANDER AGUIRRE
MY COMMISSION 8 GG 231811
PLANS I VE 1--7--- — - RO
REVIEW REVIEW i REVIEW REVIEW