HomeMy WebLinkAboutGrimm Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: - 9-1 Z Permit Number:
m o -
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
PERMIT APPLICATION FOR: Tile reroof
PROPOSED IMPROVEMENT LOCATION:
Address: Z44 NVV 5eagrass Dr,
Property Tax ID #. 4426-805-0012-000-8
Site Plan Name: Grimm Residence
Project Name: Grimm
I DETAILED DESCRIPTION OF WORK:
TILE REROOF
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
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: 32.36
Cost of Construction: $
Generator
Residential X
Lot No.
Block No.
W1in�dows/D000rs _ Pond
r Roof 6 Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
Building Height: M_
OWN ER/LESSEE:
CONTRACTOR:
Name FRED GRIMM
Address: 2227 NW SEAGRASS DR
Name: ARTHUR FRANK
Company: ROOFING SYSTEMS OF FLORIDA INC
City: PALM CITY State: _
Zip Code: 34990 Fax:
Phone No. 419-509-
Address: 583 105TH AVE N STE 9
City: ROYAL PALM BEACH State: FL
Zip Code: 33411 Fax:
Phone No 561-795-5566
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
IS—I. r_
E -Mail ADM IN@MYROOFSYSTEM.COM
State or County License CCCO29554
-- - -- - __.... -1 ... a %.WnL#t;u wvLILe Ur Lummencement 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
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
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 or recording your Nojlice of Commencement.
Signa ure of Owner/ Lessee/Contractor as Agent for Owner Signature f Contractor/License
STATE OF FLORIDA? „ "� STATE OF FLORIDA
COUNTY OF !l�/ `QF A`-- COUNTY OF a&_ hQ. rc
Sworn to (or affirmed) and subscribed before me of
!� Physical Prese, ce or Online Notarization
thi day of ft. t- 2020 by
Name of person making statement
Personally Known OR Produced Identification F
Type of Iden ioli
Produ ecl ✓.� .rc''
{Signature of Notary Publ
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C L E N E D I L L I N G E
of Flori
Commission No. =_� *-NC�r ✓kion #kt ate GG ,45635+
My Commission Expires
April 03, 2024
Sworn (or affirmed) and subscribed before me of
Physical Pres ce r Online Notarization
this day of 2020 by
Name of person making statement.
Personally Known i�l/O°R Produced Identification
Type of identification
Produced
ignature of Notary Publ - z-----m�--
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,,tP oa>ARLENC DILLINGEI
mmission No. ` a "C�a Jic-State of Florid
on # GG 956356
°F }10 �Y Comr7iisHion Expires
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5