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Building permit application
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATloN TO BE ACCEPTED Date: 6/05/2020 Permit Number: Building Permit Application Planning and Development Services Building and code Regulation Divjsjon Commerc.lal 2300 Virgin.ia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Residential yes Address: 5931 Alexandria circle Property Tax lD #: Site Plan Name: Project Name: 3410-503-0184-000-5 Lot No.15 Block No. F I/'\ /I,-)` iA,`. i\ \,<i\ ^{ii.`.,1`&`" +iv \rr,.\,L'`, .,., ./. ` \1`,`` .->( /`A, i I '+,I. \i,I, ,,`,I. C,+'T\-[`_`\,`\`, /,\,`.,,\.-I)`'L \[/<.\,-:;''`,.,^`\`),\1 [``-rp^ `1~'T:,-:(```/i\`;,`\``2\` .,..)(`` -„ , :,,; , , '",.,.7 i: `,, '.(, \.1\ y,` (-' ,=Y--,` , ,,`{ , i !` ,-,`-: ,i:`,`:,`` ;I,`< , '``. ,'1, `-; `J_,`, I f' T ``,I.;'`." .T`^`;|' \f'`i".\,\/.r`,/(`{'.`^` i ?.'' n", )A,V\`\r„ /'1/,1 t_I ` `,h `l=l`}v././`,(\ I, , ,^,,a/,,`c<,,., ,`,I.,., )l\h +„1/, ` i,-_ ,.,)?., ,T`,, >,`. L^ shingles to shingle fl 18355 peel and stick underlayment fl 16048 New Electrical Meter Second Electrical Meter Additional work to be performed under this permit -check all that apply: Mechanical Gas Tank Gas piping Shutters Windows/Doors Pond Electric Plumbing _Sprinklers Generator #Roof Total Sq. Ft of Construction: Cost of Construction: S 2800 1 0500 Sq. Ft. of First Floor: 5/12 pitch Utilities: Sewer _ Septic Building Height: ;;,E • :;I;,z'.i.`',,r,#,..`-,.,...I-.,: ,., ::(;"..`:•.,I,-.`',`'-`',:.•'',:.'(`:.I.-',','.-.,`(.+i.,,`;j`„ii`\,-I-.,-,.''(<'.,,c,:`.,?if - ,,, ,.+ , ,,,- -'< -',, r , , ,: A `- Name Rebeccad© Cbcp,a A 0 6^Name:Roland Wiley Address: 5931 Alexandria Cirofe com an .Shoreline Roofing LLC city: Fort pierce State: ELL Address: 1973 SW Glendale St zip code: 34982 Fax:city: Port st Lucie state: FL Phone No.zip code: 34987 Fax: E-M ail:Phone No772-260-9565 Fill in fee simple Title Holder on next page ( if different E-Mail shorelineroofing@yahoo.com State or County License CCC1331170from the Owner listed above) lf value of construction ls 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. ir h +I_`5`Esia.iiEfi';Eii GliiiEE`R: Not Applicable MORTGAGE COMPANY: Not Applicable N.Name. Address:Address:City: State: -city: State: Zip: Phone Zip: Phone: FEE SIMPLE Tl TLE HOLDER:Not Applicable BONDING COMPANY; Not Applicable N.Name. Add.Address. C.t.City: Zip, Phone:Zip: Phone, OWNER/ CONTRACTOR AFF lDVIT: 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. ktfuL!u!cj;:#c:gn:T:cT:w:,!i,:aowiteipp|Fju:,anii:t##hfra!#iars:t#aotafopan?i:oTnitr:i##Jh:o#sz;erte:d:Fo:,:.#nj#egs|g,:crti8nSua#.!#f#ai:p:r,Syttriubi!usruech ln conslderatlon of the grantlng of this requested permit,I do hereby agree thlnaccordancewiththeapprovedplans,theFloridaBuildingCodesandSt.Luci t I will, in all respects, perform the workCountyAmendments. The following bull dlng permit app icatlons are exempt from undergoing a full concurrency review: room additlons, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another nan-residential use WARNING TO OWNER: Your failure to Re#:p#?frm:ifFs:t:o!y!s:t:enger;n::#yrjeoA::, i§i:§a:°;;r::tE:Cie:i:I:ijt|¥#i;e;n!;§§:vi:§e;:Neriit8[!::e;:ft!n:o¥i:e;!n#C!: forcrecords of St.ancing,consultment. Signature Of Owner/ Lessee/Contractor as Agent for Owner Signature Of Contractor/license Holder €bAUTF£FOFFLORF+rrfujoij €bAUT#FOFFL°R'EL.churl.4 fuffi#i:En:cii=edbeforemeofOnlineNotarization2020by ¥p:;s`i:ra,aF::Teendc'ea:rdsubscr;bne,fn:ef:i:rTz:t::nthisj|IAdayofri/v4a202oby fu\onf\ U . I ::r:oen:i[:eKr:::nmak7statoeRmperno¥uced,dentification_::r:oen:;I;eKr::::a#StatoeRm:rno¥ucedidentification_ Type of ldentific ation Type of Identification ap#Adr ulmto Produced Thnmrh I ulcctu ::I:n;:sus::n°fN¥±|:C-Stat af FLnriAa] _ _RE'oRE I axpiros n NOGG \ Q2S3 §§jj,`` „§t{{[[{f #y;p;:[§cE:::t#0E EFlo,I28ei'®l REVIEWS FRONT _,,,,,,'-|,,q, \,\,. -- VEGETATloNG_SUPERVISOR -p_LANS SEATITRTLE--MANGR-bv~E COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATERECEIVED DATECOMPLETED Rev. 5/6/20