HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
COUNTY ~~
F L O R 1 D A ~- --
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 TYPE: RE-ROOF
PROPOSED IMPROVEMENT LOCATION:
Address: 8003 NORTH BLVD
Property Tax ID #: 1301-607-0382-000-1 Lot No.25
Site Plan Name: Block No. 86
Project Name: HAMM
DETAILED DESCRIPTION OF WORK:
REMOVE EXISTING SHINGLES AND REPLACE WITH 1" NAIL STRIP STANDING SEEM METAL
CONSTRUCTION INFORMATION:
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 5/12 Pitch
Total Sq. Ft of Construction: 2,617 Sq. Ft. of First Floor: 2,617
Cost of Construction: $ 16,650.00 Utilities: Building Height: 8~ _Sewer _Septic
OWNER/LESSEE: CONTRACTOR:
Name ALFRED & MAIBRITT HAMM Name: ALUNDA RUTHERFORD
Address: 8003 NORTH BLVD Company: DAVIS BROTHERS ROOFING LLC
City: FORT PIERCE State: Address: PO BOX 7115
Zip Code: 34951 Fax: City: PORT ST LUCIE State: FL
Phone No. Zip Code: 34985 Fax:
E-Mail: Phone No 772'905-8196
Fill in fee simple Title Holder on next page (if different E-Mail WANDAP@DAVISBROSROOFING.COM
from the Owner listed above) State or County License CCC1332495
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con lict 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 01'IrNER: 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 NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Signature of Contractor/License Holder
STATE OF FLO ~D -
COUNTY OF ~ ~~(,(',ISC,
The forgoing instrument was acknowledged before me
this day of , 20 by
The for oing instru • ent was acknowledged before me
this day of ~ , 20~L by
Name of person making statement.
Personally Known OR Produced Identification
Name of person making statement.
Personally Known ~ OR Produced Identification ~,
Type of Identification Type of Identification
Produced Produced ~
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, ::~;.A~~'~•,, KRYSTAL PATTERSON
'~ ~•_►. ~° " Commission # GG 343982
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,o .Expires July 28, 2023 -'F ~" ~ °P ~ Bonded Thtu Troy Fain Insurance 800-' OF f~, i..~~
(Signature of Notary Public- State of Florida)
Commission No. (Seal)
(S'ign to e o Notary Public- State'Clf~'f0~ -
Commission No.C,~(~ ~ ~ ~~ ~~ (Seal)
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REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
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DATE
RECEIVED
DATE
COMPLETED
rev. 2/7/19
6-7019 '
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