HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: OCTOBER 6, 2020 Permit Number:
91r4
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:RE_ROOF
PROPOSED IMPROVEMENT LOCATION:
Address: 5302 DEER RUN DRIVE
Property Tax ID #: 1313-502-0079-000-9 Lot No.502
Site Plan Name: Block No.
Project Name: HAKKANI
OR.
REMOVE EXISTING SHINGLE ROOF AND REPLACE WITH 26 GAUGE 1" NAIL STRIP STANDING SEAM
New Electrical Meter Second Electrical Meter
CONSTRUCTIO RMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters -Windows/Doors _ Pond
_Electric _Plumbing _Sprinklers _Generator _Roof 6112 Pitch
Total Sq. Ft of Construction: 3,973 Sq. Ft. of First Floor:
Cost of Construction: $ 20,050.49 Utilities: _ Sewer _ Septic Building Height:
OWNER/L
NTRACTOR:
NameKAJl G HAKKANI
Name:ALUNDA RUTHERFORD
Address:5302 DEER RUN DRIVE
Company-DAVIS BROTHERS ROOFING, LLC
City: FORT PIERCE State: _
Address: PO BOX 7115
City: PORT ST LUCIE State: FL
Zip Code: 34951 Fax:
Phone No.
Zip Code: 34985 Fax: 772-210-7801
E-Mail:
Phone No772-905-8196
Fill in fee simple Title Holder on next page (if different
E-Mail WANDAP@DAVISBROSROOFING.COM
State or County License CCC1 332495
from the Owner listed above)
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:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 attornev before commencing work or recording your Notice of Commengement.
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Signature of Owner/ Lessee/Con ctor as Agent for Owner
Signature of Contractor/License Hblder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFSTLUCIE
COUNTY OFSTLUCIE
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or
Online Notarization
x Physical Presence or _ Online Notarization
this eTM day of OCTOBER
. 2020 by
this STH day of OCTOBER 2020 by
ALUNDA RUTHERFORD
ALUNDA RUTHERFORD
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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