HomeMy WebLinkAbout6709 santa clara blvd permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: June 3 2020
gy. LUcUP y :.
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential X
PERMIT APPLICATION FOR:MY FLORIDA ROOFING CONTRACTOR
Address: 6709 SANTA CLARA BLVD
Property Tax ID #: 1301-611-0380-000-0
Site Plan Name:
Project Name: Dave's Rental Property Re -Roof
Lot No.27
Block No. 117
Remove and replace old shingle roof with new peel & stick underlayment followed by 26 guage mill 5V metal roof
Existing flat roof to remain
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: 2,000
Cost of Construction: $ 9700.00
Sq. Ft. of First Floor:
_ Windows/Doors _ Pond
Roof 4 in 12 Pitch
Utilities: —Sewer _Septic Building Height: 12'
Name Dave Wilson
Address: 6709 SANTA CLARA BLVD
City: Fort Pierce State: _
Zip Code: 34968 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: Rene Reyes
Company: My FLorida Roofing Contractor
Address:1140 17th Place
City: Vero Beach State: FI
Zip Code: 32960 Fax:
Phone No772-453-7219
E-Mai I cs@myflroofingcontractor.com
State or County License CCC1 326546
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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.
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 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first ins tion. If you intend to obtain financing, consult
w' r or a before commencing work ecordi yqCommencement.
Signs re o caner/ Le see/Cont actor as Agent for Owner
Sign ture Contr tor/ icense H Ider
IF
STAT OF FLORIDA
COUNTY OF �n�.�®. n' ��
STATE OF FLORIDA
COUNTY OF .=-C Qkk0't-i
Syrorn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this .3 day of 2020 by
Sw,;n to (or affirmed) and subscribed before me of
�C Physical Presence or Online Notarization
this 3 day of .�.,��. 2020 by
Name of person making statement.
Name of person making statement.
Personally Known iC OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- r'
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Commission No. +� H Esty
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ignature of Notary Public- State of Florida )
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