HomeMy WebLinkAboutPermit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
S -I J i zja.
•
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: 1203 Driftwod Ln Fort Pierce FL 34982
Legal Description: DRIFTWOOD MANOR -SECTION THREE -LOT 14 (0.50 AC) (OR 4002-562)
Property Tax ID #: 3404-808-0014-000-0
Site Plan Name: Alan or Laurie Periello
Project Name: Alan or Laurie Perielle
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Remove existing roof system and replace with new
Lot No.
Block No.
5v Metal (FL17020-R7) Skylight (17-1023.18)
Tribuilt Smooth (FL16048-R6)
Off Ridge Vent FL16994-R5
CONSTRUCTION INFORMATION:
Additional work to je`oe orme under this permit— check a apply:
L
E1HVAC J Gas Tank Gas Piping _ Shutters Windows/Doors
11 Electric 0 Plumbing U Sprinklers Generator Roof 5112 Roof pitch
Total Sq. Ft of Construction: 44
Cost of Construction: $ 24,860.00
S Ft, of First Floor: _
UtilitiesIn Sewer OSeptic
Building Height: 1 Story
OWN ER/LESSEE:
CONTRACTOR:
Name Alan or Laurie Perriello
Name: Dee Keihn
Address: 1203 Driftwod Ln
Company: PDKRoofing.lnc
City: Fort Pierce State: FL
Zip Code: 34982 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)
Address: 1299 SW Biltmore Street
City: Port Saint Lucie State: FL
Zip Code: 34983 Fax:
Phone No. (772)528-0113
E-Mail: PDKRoofing.lnc@gmaii.com
State or County License: CCC1331408
ii vaiue ur consirucuon is >zSuu or more, a KILLUKutu Notice of commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
vMIM/ LUIV 1 KAL I UK ArrlluVll 1 : 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
before thSAqst inspection. If yov7intengto obtain financing, c u ith lender or an ttorney efore
commen ing Work or recor<din�our N tice of Commencem .I
Sigh-aPZe of Owner/ Lessee/ ntractor as Agent for Owner
fgna ure of Contractoceke Holder
STATE OF FLORIDA
COUNTY ST Lc�t+ut
STATE OF FLORIDA
OF . _
COUNTY OF SIT, • L—k-,� e_
The forgoing instrument was acknowledged before me
this day of _ 7V1ryGr20 z Eby
The f rgoing instrument was acknowledged before me
this day of 20+&0 by
Name of person making statement
Name of person making statement
Personally Known b4 OR Produced Identification
Personally Known �L_ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
e
(Signature of Notary Public- State o ida)
(Signature of N dry Public- Stat of Flor da }
Commission No.
••... AI.E) DE AGUIRRE
Commission No.
:
MY COMMISSION#GG234811EXPIRES:Ju
ALEXANDERAGUIRRE
4 2422
MY COMMISSION # GG 234811
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COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REV E
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17