HomeMy WebLinkAboutPermit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
t� _
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 I
PROPOSED IMPROVEMENT LOCATION:
Address: 5402 Palmetto AVE Fort Pierce, FL 34982
Lega I Description: WHITE CITY S 152.86 FT OF N 345.72 FT OF W 530 FT OF OUTLOT 11 AND S 22.14 FT OF BLK 79 AND N 40.72 FT OF BLK SO AND VAC 7 ST
LYG BTWN ELKS 79 AND 80-LESS E 141.59 FT OF W 530 FT OF OUTLOT 11- (1.69 AC)
Property Tax ID #: 3404-501-0556-200-1
Site Plan Name: Steven Burns
Project Name: Steven Burns
Setbacks Front Back
Right Side: Left Side:
Lot No._
Block No.
DETAILED DESCRIPTION OF WORK: I
Remove existing flat roof and replace with new flat roof
Modified Bitumen Roof System(1654.1)
CONSTRUCTION INFORMATION:
Adaitional work to b
jrformed under this permit —check all h apply:
�HVAC LJ Gas Tank Gas Piping In Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers ❑ Generator Roof 0 IZ Roof pitch
Total Sq. Ft of Construction: 600
Cost of Construction: $ 7,000.00
S Ft. of First Floor: _
UtilitiestSewer OSeptic
Building Height: 1 Story
OWNERAESSEE:
CONTRACTOR:
Name Steven Burns
Address: 5402 Palmetto AVE
Name: Dee Keihn
Company: PDKRoofing.lnc
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. (772)528-0113
E-Mail: PDKRoofing.lnc@gmail.com
Address: 1299 SW Biltmore Street
City: Port Saint Lucie State: FL
Zip Code: 34983 Fax:
Phone No. (772)528-0113
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: PDKRoofing.lnc@gmail.com
State or County License: CCC1331408
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNE
Name:
Address:
City:
Zip: Pho
. � Not Applicable
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
ZIP: Phone:
BONDING COMPANY:
Name -
Address:
City:_
Zip:
Phone:
Not Applicable
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
befor -the first Inspectiori, If, intend to obtain financing, consult with lender or an
$torne� before
m conci work or rcsffng vout' Notice of Commencerrrent_ , —�
LC
Signature of Owner/
for Owner I Sim re of contractor%i' ensr� a Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF _ Lug C' COUNTY OF - . L i�l '
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this S_] day of Sul 20 ' by this 17 day of 'T 20� by
Dew KIP,lx^
Name of person making statement
Personally Known X_ OR Produced identification
Type of Identification
Produced
Name of person making statement
Personally Known L.. OR Produced Identification
Type of Identification
Produced
(Signatu of Notary Public
t of Florida)
(Signature
6LNota
Commission No.
' . AIEa A(NJFM
Commission
No. ��'
ALEXANDER OUiR
YCAMMI��G(32 348i1
;.i MYCOMM11 8M100234811
• ...d.
E)nf i S: July 4, 2022
EltRi: July 4, 2Q22
RES.
6,•
4°
SW" ThN Notary Publk VMwwiMmt
REVIEWS
FRONT
ZONING SUPERVISOR
PLANS
VEGETATION SEA
TURTLE MANGROVE
COUNTER
REVIEW REVIEW
REVIEW
REVIEW
REVIEW REVIEW
DATE
-RECEIVED
DATE
COMPLETED
Rev.8/2/17