HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 06/22/2020 Permit Number:
O
c c c c rz Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential Re -Roof
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
ul W-�gs�, I I i04
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #: 1313-502-0041-000-4 Lot No. 464
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Remove existing shingle roof and replace with metal roof, remove existing flat roof system and replace with TPU
single ply roof system
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New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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 5/12 hTu Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 21,000.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: Scott Chapman
Address:
Company: American Roofing, L.L.C.
City: State: _
Address: 2207 US Hwy 441 SE
City: Okeechobee State: FL
,Zip Code: Fax:
Phone No.
Zip,Code:•34974 Fax:
E -Mail:
Phone No863-763-9119
Fill in fee simple Title Holder on next page ( if different
E -Mail reception@btcbuilders.com
State or County License CCC1 327071
from the Owner listed above)
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.
SUPPiLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
City: State:
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 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.
Luc i�r County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
wit lender or an attornev before commenciniz work or r ordiniz vour Notice of Commencement.
ure of Own er/'I`esee/Contractor as AeZ�kt for Owner
STATE OF FLORIDA
COUNTY OF QgeLhabu�
SVprn to (or affirmed) and subscribed before me of
b ical Presence or Online Notarization
this ay of __,2020 by
&�+_ owin a
Name of person making stat ment.
Personally Known k OR Produced Identification
Type of Identification
Produ d
(Signa re Notary Public- State of Florida )
Commission No. Z"' ANGEOA*STEVENS
Notary Public - State of Florida
1p` Commission X GG 925749
REVIEWS
CO
DATE
RECEIVED
DATE
COMPLETED
re of C37Stractor/License Hol
STATE OF FLORIDA
COUNTY OFokeechobee
Sworn to (or affirmed) and subscribed before me of
X Dhv ical Prese or Online Notarization
this k4y of ILAhe 2020 by
Scott Chapman
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Prod ed
(Si"I I JG�
gnareNotary Public- State of Florida )
Commission No. :v<".• ANq IESTEVENS
Notary blit /State of Florida
:ate �A Commission M GG 925749
RAINS VEGETATION rrPiiit�iiG�i6
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