HomeMy WebLinkAboutDeven Allen Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
- w J _ _
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: 169 Huber Drive, Fort Pierce Florida 34946
Legal Description: RIVERVIEW MANOR BLK B LOTS 7, 8 ANDS (OR 3966-940)
Property Tax ID #: 1408-703-0039-000-5
Site Plan Name: Deven Allen
Project Name: Deven Allen
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: I
Remove existing flat roof and replace with new Modified Bitumen Roof System (FL1654-R23)
CONSTRUCTION INFORMATION:
itionalwor to be ertormed under this permit –check all that apply:
HVAC Gas Tank E]Gas Piping Shutters []Windows/boars
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 2200 S Ft. of First Floor:
Cost of Construction: $ 12,600 Utilities. — Sewer E]Septic Building Height: 1 Story
OWNER/LESSEE:
CONTRACTOR:
Name Deven Allen
Address: 169 Huber Drive
City: Fort Pierce State: FL
Zip Code: 34946 Fax:
Phone No. (772)528-0113
E -Mail: PDKRoofing.lnca@gmail.com
Name: Dee Keihn
Company: PDKRoofing.lnc
Address: 1299 SW Biltmore Street
City: Port Saint Lucie State: FL
Zip Code: 34983 Fax:
Phone No. (772)528-0113
E -Mail: PDKRoofing.lnc@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: CCC1331408
If value of construction is $2500 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 BOLDER: 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.
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 thepermit 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 th irst inspection.,xf you iptend to obtain financing, coy►%ult with lender o�,an att y before
comm in work orv-ecc�6rdinE vGlur Notice of Commencement. ; /-► /
Rev. 8/2/17
Signature of Owner/ essee/Contractor as Agent for Owner
Signature of Contr tar/License Holter
STATE OF FLORIDA
ST_ Lie
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The for oing instr ment was acknowledged before me
The forgoing instrument was acknowledged before me
��
this day of 1 PI IM f 2Q 20 by
this �3 day of . / 2Qi by
Imo'
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Sig ature of Notary Public- State of arida y
(Signature f Notary Public- State of orida
Commission No.,•A: 4j.V AI.EMN &Jk U1RRE
Commissio
ALEXANDERMIYRE
MY COMMISSION # GG 234811
MY COMMISSION # GG 234811
; t e• EXPIRES: July 4, 2022
EXPIRES' Jul4 2032
4r,R ? ' nded Ther Notary Public L ndenwdlers
ZONING
REVIEWS
FRONT
SUPERVISOR
PLANS
VE OVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17