HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
4 = . 0 .
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: 11001 Ridge Ave, Fort Pierce, Florida 34982
Legal Description: B S HARRIS' S/D BLK 5 LOTS 9, 10, 11, 12, 13 AND S 4 FT OF LOT 14-LESS RR R/W
Property Tax ID#: 3532-503-0069-000-8 Lot No.
Site Plan Name: Kenneth Steiger Block No.
Project Name: Kenneth Steiger
Setbacks Front Back: Right Side: Left Side:
DETAILED DE5CRIPTION OF WORK:
Remove existing roof system and replace with new
5V Metal (FL1 7022-R7)
Tribuilt Smooth (FL16048-R6)
[_CONSTRUCTION INFORMATION:
Additional work to e performed under t ispermit—check a apply:
0HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
11Electric 0 Plumbing ElSprinklers Generator Z Roof 4112 Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 12,250.00 Utilities: Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Kenneth Steiger Name: Dee Keihn
Address:11001 Ridge Ave Company: PDKRoofing.lnc
City: Fort Pierce State:FL Address: 1299 SW Biltmore Street
Zip Code: 34982 Fax: City: Port Saint Lucie State:FL
Phone No.(772)528-0113 Zip Code: 34983 Fax:
E-Mail: PDKRoofing.lnc@gmail,com Phone No. (772)528-0113
Fill in fee simple Title Holder on next page( if different E-Mail: PDKRoofing.lnc@gmail.com
from the Owner listed above) State or County License: CCC1331408
If value of construction is$25fl0 or more,a RECORDED 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:
OWNER/ CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to clothe 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 f ' ure to Record a Notice of Commencement may result in your paying twice for
improvements to your pro rty. A Notice of Commencemen us a recorded an posted on the jobsite
before a irst ins c io . If yo intend to obtain financin , consul with le r an at rney before
com ncin we or cordin our Notice of Commence t.
Signature of Own /Lessee ontractor as Agent for Owner Signature o ontr or/License Holder
STATE OF FLORIDA STATE OF FLORIDA r�
COUNTY OF Uka COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this j2L day of NWUAhtJ( 20 't) by this ;— day of rJWWf ,20_JV by
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
S L4�
4Ca���, ��
(Signat re of Notary Public-St a of Flori (Signature of Notary Public-5�tate of FI da )
Commission No. eal) Commissio
ALEXANDERAGUIRRE
MYCQMMISSION#GG 234811
*: MY COM ISSION#GG 2 'Fo'F d��.".� nded to Public Unde IerS
REVIEWS NIT EX F@g p� SU RVISOR PLANS GROVE
�rF�ITb I l�ndar eraR VIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17