HomeMy WebLinkAboutHart Permit App.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -//o�J�e�Daa Permit Number:
T L IE
OU N-T'Y
F L O R_IQjwAsl
Planning and Development Services
Building Permit Application
Building and Code Regulation Division Commercial
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential x
PERMIT APPLICATION FOR:AIIiance Group -----Gregory Hart
'PP&OPOSED IMPROVEMENT LOCATION: Roof replacement
Address: 3067 Charles Way Fort Pierce, FL 34946
Property Tax ID #: 1428-802-0007-000-8
Site Plan Name:
Project Name: Gregory Hart
DETAILED DESCRIPTION OF WORK:
Remove existing roof, renail deck, install self -adhered underlayment and install GAF Timberline shingles
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply:
Lot No.
Block No.
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors _Pond
_ Electric _ Plumbing _ Sprinklers _ Generator X Roof 4/12 Pitch
Total Sq. Ft of Construction: 2,500
Cost of Construction: $ 11,000.00
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:10'
OWNER/LESSEE:
a
CONTRACTOR:
Name Gregory Hart
Name: Danielle Ryckman
Address: 3067 Charles Way
Company: Alliance Group
City: Fort Pierce State: _
Zip Code: 34946 Fax:
Phone No. 941-587-6029
Address:615 NW Enterprise Drive
City: Port saint Lucie State: FL
Zip Code: 34986 Fax: 772-492-8008
Phone No 772-492-8006
E -Mail: flanchorgreg@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail adamleeryckman@gmail.com
State or County License CCC 1330918
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ 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.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing Work.Qr recording vour Notice of Commencement.
Rev. 5/b/LU
Sign e o Owner/ Lessee/Contractor as Agent for Owner
Signatur f Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF santt
COUNTY OF sa a
SwPin to (or affirmed) and subscribed before me of
Sw to (or affirmed) and subscribed before me of
Pres o _Online Notarization
Physical Prese a Online Notarization
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this day of J + 1 2020 by
this 'I day of 2020 by
Name of person making statement.
Name of person making statement.
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Personally Known x OR Produced Identification
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DATE
RECEIVED
DATE
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Rev. 5/b/LU
SKETCH REPORT I AREA DIAGRAM
3067 Charles Way
Customer
Prepared by
Fort Pierce FI
Gregory Hart
Adam Ryckman
34946
3067 Charles Way
615 Nw Enterprise Drive, Port
June 27, 2020
Fort Pierce, FI 34946
Saint Lucie, FL 34986
9415876029
(772)492-8006
adamleeryckman@gmail.com
AROOFSNAP SKETCH REPORT I AREA DIAGRAM tj