HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
_ ._
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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: 920 Jackson Way, Fort Pierce, Florida 34949
Legal Description: COASTAL COVES -UNIT 1- LOT 6
Property Tax ID #: 1423-802-0009-000-7
Site Plan Name: UDT/SEAL MUSEUM ASSOCIATION INC
Project Name: UDT/SEAL MUSEUM ASSOCIATION INC
Setbacks Front Back: Right Side
I DETAILED DESCRIPTION OF WORK:
Left Side:
Remove existing roof and replace it with new 5V Metal Roof system
Tri-Built Smooth (16048.1), 5V Metal (17022.1), Off Ridge Vents (16994.1),
Flat Modified Bitumen Roof System (1654.1),
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work to a er orme under this permit —check a apply:
�HVAC 11 Gas Tank []Gas Piping _ Shutters ❑ Windows/Doors
Electric ❑ Plumbing ❑ Sprinklers Generator W1 Roof 4112 Roof pitch
Total Sq. Ft of Construction: 3500.40
Cost of Construction: $ 26990
S Ft. of First Floor: _
Utilities: Sewer E Septic
Building Height: 1 story
OWNER/LESSEE:
CONTRACTOR:
Name UDT/SEAL MUSEUM ASSOCIATION INC
Name: Dee Keihn
Address. 920 Jackson Way
Company: PDKRoofing.lnc
Address: 1299 SW Biltmore Street
City: Fort Pierce, State: FL
Zip Code: 34949 Fax:
City: Port Saint Lucie State: FL
Phone No. (772)528-0113
Zip Code: 34983 Fax:
E-Mail: PDKRoofing.lnc@gmail.com
Phone No. (772)528-0113
Fill in fee simple Title Holder on next page ( if different
E-Mail: PDKRoofing.lnc@gmail.com
from the Owner listed above)
State or County License: CCC1331408
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: _ Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address-,
City:
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.
5t. 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, wails, 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 Commencement must be recorded and posted on the jobsite
befor -the first inspectio If intend to obtain financing,yonsuit with lender or an ttorne before
com nci work or rec��ou/ Notice of Commencerrfent., - - � l
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Signature of Owner/less a/Contractor a ent for Owner Si ure of ContractofIlLifense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF -- - Lam+ _ c COUNTY Of 4SY. IL L;-CL C
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 30 day of $LAre , 20_2n!� by this 30 day of Sin e 202-V by
Name of person making statement
Personally Known X_ OR Produced Identification
Type of Identification
Produced
Det,_ ke.,V\--
Name of person making statement
Personally Known k?!;._OR Produced Identification
Type of Identification
Produced
(SignatuAtof Notary Public- t of Florida) (Signature ota
Commission No. r`' ALEi(611DE tJ1U420:
Commission No. ' ALEXANDERAGUIRR6
YCOh4At1 �► GG Mail
MY CQir4rV118310NEXPIRES. July 4, 2022
a*FIRES: Jiffy •..,e►i 4 Bonded Thru Notary F'uc Uletllrwlllers
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW j REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED T
DATE
COMPLETED
Rev. 8/2/17