HomeMy WebLinkAboutPermit ApplicationS7" LUCIE
AIIAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:Permit Number:
Building Permit Application
Planning and Development Seruices
Building and Code Regulation Division
2j00 Virginio Avenue, Fort Pierce FL 34982
Phone: (7721 462-1553 Fax: (7721 462-7578
Commercia I Residential x
PERMIT APPLICATION FOR: ftg;Ogf
PROPOSED IMPROVEMENT LOCATION:
Address: 6007 Citrus Avenue
Property Tax lD #:3409-31 1 -0008-000-5 Lot No
Site Plan Name:Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Remove shingle roof and renail plywood. Apply MTS self adhering modified bitumen underlayment. lnstall
dimensional shingles.
New Electrical Meter Second Electrical Meter
CONSTRUCTI ON I N FORMATIO N :
Additional work to be performed under this permit - check all that apply:
_Mechanical -
Gas Tank _ Gas Piping
_ Sprinklers
_ Shutters
-
Windows/Doors
-
Pond
-
Generator
-
Roof 6112 Pi1s6_ Electric _ Plumbing
Total Sq. Ft of Constru5l;6n' 4600 Sq. Ft. of First Floor:
Cost of Construction: $ $17,500'oo 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:
N.mgTim Thornton
Address: 6007 Citrus Ave.
City: Ft' Pierce State:f!
ZiP Code: 34982 Fax:
phone 11s.370-0785
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.
4661s55.2182 NW Reserve Park Trace
city: Port St. Lucie State: FL
ZiP Code: 34986 p2y1. 772-468-9978
phone 616772-468-3723
g- 1y 2 ; 1
ssm ith @packard roofi n g. com
State or CountY 1;6sn5gCCCA17517
SUPP IEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
' Not Applicable
Address:
City:State:
zip:Phone
MORTGAGE COMPANY , Not Applicable
Name:
Add
City
zip:
ress:
:State:
Phone
FEE SIMPLE TITLE HOLDER:* Not Applicable
Name:
Add
City
7ip:
ress:
Phone:
BONDING COMPANY: P Not Applicable
Name:
Address:
City:
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.
i,)n[tiis ,i".T,']f,[i],ii ?il",'J;f3l*t'ff3*lEb'i,H!?!i!g"1Bti'# iil,xi:#,]l]",,r;I:if:3xJl:fiig?il? H?jlitlf i.1ojFiliH,1,iliL1r,
&i.rli,ii.i.'prEii" iri"iijli'atltl',io,IiHirirdo;v;d;i'Asio;'ration 'a;d ievi6w'ioui tieed for any restrictions Which mav applv.
ln consideration of the granting of this requested permif I do hereby agree that I will, in-all respects, perform the work
in accordance with the ipprou6d plans, the Floridi 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, fencet wallg signs, screen rooms and accessory uses to another non-residential use
COUNTY OF St- !.!..<
Sworn to (or affirmed) and subscribed before me of
nz Physical Presgnce or
16;s rf$t day of
Personally Known OR Produced ldentification
Name of person making statement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
COUNTY OF$. U..:cr, e
Swo;n to (or affirmed) and subscribed before me of"--" --/ Physical Presence or Online Notarization
Name of person making statement.
Personally Known OR Produced ldentification
Type of ldentification
EIic- ststErdfrffiort&b )':'.
Notarv Publi( - State of Fl'rid'.i'J.:'. c:--:'ll:.:!.iS'dfor
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VEGETATION
REVIEW
ZONING
REVIEW
SUPERVISOR
REVIEW
FRONT
COUNTER
SEA TURTLE
REVIEW
DATE
COMPLETED
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
imfirovements io voui prop"rtv. A Notice of Commencement must be iecorded in the public records of St.
Luiie County anJ rilrte! on tfr.ijobsite before the first inspection. lf you. intend to obtain financing, consult