Loading...
HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date Permit Number: -I _JJ • 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: 5101 Paleo Pines Cir Fort Pierce, FL 34951 Legal Description: HOLIDAY PINES S/D-PHASE II-B- LOT 340 (MAP 13/13N) (OR 1269-972) Property Tax ID #: 1312-801-0143-000-4 Site Plan Name: Brian Grothe Project Name: Brian Grothe Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Tear off existing flat roof and replace with new Modified flat roof system Modified Bitumen Roof System (1654.1) Lot No. Block No. CONSTRUCTION INFORMATION: Additional work to ff rorme un ert is permit — c ec a app y: 1JHVAC Gas Tank Gas Piping Shutters ❑ Windows/Doors ❑ Electric ❑ Plumbing ❑ Sprinklers Generator ✓❑_ Roof fl11 z Roof pitch Total Sq. Ft of Construction: 4.6 Cost of Construction: $ 5800 5 Ft. of First Floor: _ Utilities:Sewer D5eptic Building Height: 1 Story OWNER/LESSEE: CONTRACTOR: Name Brian Grothe Name: Dee Keihn Address: 5101 Paleo Pines Cir Company: PDKRoofing.lnc City: Fort Pierce State: FL Zip Code: 34951 Fax: Phone No. (772)528-0113 Address: 1299 SW Biltmore Street City: Port Saint Lucie State: FL Zip Code: 34983 Fax: Phone No. (772)528-0113 E-Mail: PDKRoofing.lnc@gmail.com 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 uawe of consiruciion Is �L7uu or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION: ©ESIGNER ENGINEER: Not Applicable Name: !MORTGAGE COMPANY Address: — Name: City: Address: State: City; Zip: one Zip: _ Phone: ritt SIMPLE TITLE HOLDER: Not Applicable Name: Address: City: Zip: Phone: — Not Applicable tare: BONDING COMPANY; —Nat 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. 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 Horne 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 inspectio . If intend to obtain financing, Sonsult with lender or an �torne before com n i work or n ou Notice of Commence nt. t _ Signature of Owner/ j ess a/Contractor a_NVent for Owner STATE OF FLORIDA COUNTY OF - . Lit C. The forgoing instrument was acknowledged before me this 2.13 day of 20,�` by r� Name of person making statement Personally Known OR Produced Identification Type of Identification Produced (Signatu of Notary Public - Commission No. Florida ) ALEK&MMiUIRM W COMMLRSM X GG 234811 EXPIRES: July 4, = REVIEWS FRONT ZONING COUNTER REVIEW DATE RECEIVED _ DATE COMPLETED Rev. 8/2/17 of Contracto(%Lifense Holder STATE OF FLORIDA COUNTY OF L k_ LL C The forgoing instrument was acknowledged before me this 28 day of 20_2�0 by i]e ertlrr, -, Dame of person making statement Personally Known A, OR Produced Identification Type of Identification Produced {Signature kNotarvgw t"t+ ALEXANDERAGUIRRE Commission No. ' � VC0MM1Ifi"iGd234811 EXPIRES: July 4, 2622 °Of , � Bonded 7hru Notary Pub1k Un& Nm SUPERVISOR PLANS I RE EW I V REV EWON I SEATURTANGRO REV EWLE 1 MREV EWVE