HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
V IJ
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 7501 Penny Lane Fort Pierce Florida 34951
Legal Description: LAKEWOOD PARK -UNIT 07 BLK 81 LOT 21 (MAP 13102N)
Property Tax ID #: 1301-607-0299-100-3
Site Plan Name: JoAnn Pennington
Project Name: JoAnn Pennington
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove Existing flat roof system and replace with new
Modified Bitumen Roof System (FL1654-R23)
Lot No._
Block No.
CONSTRUCTION INFORMATION:
Additional work toe nerformed under tispermit—check all that appy:
❑HVAC Gas Tank 0Gas Piping L__JShutters Windows/Doors
Electric E]PlumbingSprinklers ❑ Generator Z Roof Q112 Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 4,150.00
S Ft. of First Floor:
Utilities: Sewer ElSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name JoAnn Pennington
Name: Dee Keihn
Company: PDKRoofing.lnc
Address: 7501 Penny Lane
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No. (772)528-0113
E -Mail: PDKRoofing.lnc@gmail.com
Address: 1299 SW Biltmore Street
City: Port Saint Lucie State: FL
Zip Code: 34983 Fax:
Phone No, (772)528-0113
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: PDKRoofing.lnc@gmaiLcom
State or County License: CCC1331408
It value of construction is X2500 or more, a RECORDED notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: , Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing suit with lender or an attgrney before
comyfiVncing work or recordi4 vour Notice of Commence ent. �. /' Y
Signature of Okner/ Lessee/Contractor as Agent for Owner I Signature of Contrac r/License Ho
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF slT l_.l.lCi COUNTY OF a , l t�
The for oing instrument was acknowledged before me
this 2J day of-F.l 20P-0 by
Name of person making statement
Personally Known z_ OR Produced Identification
Type of Identification
Produced 4'( -\
(Signat re of Notary Public- S of ida }
The forgoing instrument was acknowledged before me
this'd day of 20DwA by
Name of person making statement
Personally Known X, OR Produced Identification
Type of Identification
Produced_ l�t,n7
(Signatkre of Notary Public- Statfrof
Commission No. Commission No.
a ALEMNDERAGUIRRE ;:0
W COMMISSION # GG 2348`11 +;
REVIEWS o Pub cundermiters - ,F°
Rin R PLANS VEG
COUNTER REVIEW REVIEW REVIEW REVIEW
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
MY COMMISSION # GG 234611
EXPIRES: July 4, 2022
ded Thru Notary Public Qriderwrfle
OVE
REVIEW REVIEW