HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _ Permit Number:
` : `UcLIl
,, C' - � Application
Building Permit A lication
Plonnirg and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: Roofing
FPR0P&SED IMPROVEMENT LOCATION: -- ---- f
Address: 6350 Peterson Rd
Property Tax ID#: 2312-41-4-0000-O00-7 Lot No.
Site Plan Name: _ Block No,
Project Name:
j DETAILED DESCRIPTION OF WORK:
r
Re-Roof BUR System
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 _Windows/Doors T Pond
Electric _Plumbirg Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: 1,019 Sq.Ft. of First Floor:
Cost of Construction:$ 25,505 Utilities: —Sewer _Septic Building Height:
OWN ER/LESSEE: ---CONTRACTOR: I
Na tile lrt cro-Cable Comm Corp l Name: Jacob Kaiogr dis
Address-One Comcast Center Company.Crown Roofing&Waterproofing LLC
City: Philadelphia _- _ State — Address:240 Field End Street
Zip Code: 19103 Fax: City: Sarasota State:F'
Phone No _ _ Zip Code: 34240 _ Fax:
E-Mail: r Phone No954-495-1739
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Fill in fee simple Title Holder on next page(if different E Mail Christineb 9•cojn
from the Owner listed above) State or County License GCC1332557
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 LAIN INFORMATION:
DESIGNER/ENGINEER: X_Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: - - ---- -- Name:
Address: ---- -____ __- ____ _---- --__---------------- --
- - ----- -- Address.- _
City
State:
•_ ...__.-.._�..___.-_. ' City: State:
I Zip: Phone -- Zip:-- - Phone:_
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable �
Name: i Name:
Address- Address:
City"
City:. y"
�
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 instaiiation has commenced prior to the issuance of a permit.
51 Lw to Count makes no representation that is granting a permit will authorve the permit firAder to burd the subject structure
which is in conibict with any applicable Home Owners Association rules,bylaws or and coven Wr ants that may-estrict or prohibit such
structure.Please consult with your Home Owners Association and review your deea 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 Notice of Co mencement.
Signature wne+/Les�ee!Contractnr as Agent for Owner i ature of Contractor/License Holder
STATE OF FLORIDA - , STATE OF FLO A
COUNTY OF-- rr�- i'� .I t � �__. ____._. COUNTY OF T)rOVpr. i
Swornto(or affirmed)and subscribed before me of ! 5 n to(or affirmed)and subscribed before me of
_(.k ysical Presence or Online Notarization ✓ Physical Presence or Online Notarization
t'!is j`': day of _E by this day of 2020 by
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a id. i s
Flame of person making statement. Narne of person~makings ement.
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Personally Known _�__ —OR Produced identification
Type Known: �/ OR Produced identification
Type of Identification Type of identification
Produced-
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Elg3#gl�4uf ce?; rN.{ ��,:Sbit�craL��lc�ri o) i {Signature Npl •PubTheresa Ly1tr)Mat I'll ,�,c=3o�z�n ; - : _ Commission#HH 02 54E►'pr. ._ , v u I Cor?�mission ,c ;o` fxpiresAugust 10,Bonded Thru Troy Fain Insurance 800-385-7019
REVIEWS ! FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 516770 — - - -- -- ----