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HomeMy WebLinkAboutPermit ApplicationST IUGilE AIIAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (7721 462-L553 Fax: (772) 462-L578 Commercial Residential x PERM lT APPLICATION FOR: pgfg91 Address: 3108 Bent Pine Dr. Property Tax lD #: Site Plan Name: 1327-741-0091-000-3 1-619e.271 Block No. Project Name: DETAILED DESCRIPTION OF WORK: Remove tile roof and renail plywood. Apply 30# felt and TU Max self adhering tile underlayment. lnstall tile using screws. New Electrical Meter Second Electrical Meter CONSTRUCTION I N FORMATION : Additiona I work to be performed under th is perm it - check a ll that a pply: _Mechanical _ Electric _ Gas Tank _ Plumbing _ Gas Piping _ Sprinklers Shutters Windows/Doors _ Pond Total Sq. Ft of Construction: kb fi Sq. _ Generato r / Roof 6/12 p;165 Ft. of First Floor: Cost of Construction: $ 42,500'00 Utilities: _Sewer _Septic Building Height: lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required. lf value of HAVC is 57,500 or more, a RECORDED Notice of Commencement is required. OWNER/LESSEE:CONTRACTOR: Name Dennis Rhodes 466pg55.3108 Bent Pine Dr. city: Ft. Pierce State: ZiP Code: 34951 Fax: phone y1s.57 4-229-7 653 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: David Packard Company: Packard Roofing & Waterproofing, lnc. 466rss5.2182 NW Reserve Park Trace City: Port St. Lucie State:FL ZiP Code: 34986 pzr' 772-468-3723 phone y46772468-3723 E- y13 ; I ssmith @packardroofi ng.com State or County 1;6sn5qCCCA17517 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION DESIGNER/ENGINEER: x Not Applicable Name: Address: City:State: zip:Phone MORTGAGE COMPANY: x Not Applicable Name: Add City zip: ress: ;State: Phone: FEE SIMPLE TITLE HOLDER: x Not Applicable Name: Address: City:. zip:Phone: BONDING COMPANY: x Not Applicable Name: Address: City: zip:Phone: OWNER/ CONTMCTOR 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 subiect structurewhlch ls ln contlict with any applicable Home Owners Association.rules, bylaws or and covenants that mav restrict or prohibit suchstructure. Please consult with your Home owners Association and review'your deed foiiny iestliitio-ni vJhiah'm;y ;6p[ - ' --' ln consideration of the granting of this requested permit, I do hereby agree that lwill, 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 iecorded in ihe public records of St. Lucie.County and posted on the jobsite before the first inspection. lf you intend to obtain financing, consultwith lender or an attorney before commencing work or relordins vour Notice of Commeniement. STATE OF FTORIDA COUNTY OF.tL.L.rcle Sworn to (or affirmed) and subscribed before me of./ pfrvilcat Presence or Online Notarization this 2!Say of actor'p t ,2O2O by 'actor as Agent for Owner Name of person making statement. Personally Known ,/ OR Produced ldentification Type of ldentification Produced (Signature of Notary Public- Commission No. STATE OF FLORIDA COUNTY OF -fF, LoLt'€ Swo_;.n to (or affirmed) and subscribed before me of./ Physical Presence or _ Online Notarization this _ day of , 2020 by fur/,Vtr-laeLe{& Name of person making statement. ,/ Personally Known OR Produced ldentification Type of ldentification (Signature of Notary Public- NO:ary rJ5 C - ).::a ai ilOf,da i . i" - r*-r.. ^^ r a( 1lc<)r' ,(ggdffnm :s on i G . 1lli24 - ' ,VyComm. E^o,res 5e c 2 2021 ;'.f ,o,;-,, +,iis Ecnded rhrough fiaticnal Nctary Assn. ZONING REVIEW SUPERVISOR REVIEW MANGROVE REVIEW DATE COMPLETED [,1y Comm. ExDire; Sep 2, 2021 BcrCd tircugl' tra{iciel l\cte.y A$.