HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE 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: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 403 E Easy Street Fort Pierce Florida 34982
Legal Description: INDIAN RIVER ESTATES-UNIT-02-BLK 13 LOTS 13 AND 14 (MAP 34/11S)
Property Tax ID#: 3402-603-0203-000-7 Lot No.
Site Plan Name: Jerry McElrath Block No.
Project Name: Jerry McElrath
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove existing roof system and replace with new.
Standing Seam (FL17022-R7) Tribuilt Smooth (FL16048-R6)
SAV-SAP (FL1654-R23)
CONSTRUCTION INFORMATION:
ACIClitional work to e er orme un er t Is permit—c ec a �pp11HVAC Gas Tank Gas Piping rs Q Windows/Doors
11 Electric 0 Plumbing Sprinklers E Generator Z Roof 4/12 Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ 21,000.00 UtilitiestSewer E Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameJerry McElrath Name: Dee Keihn
Address:403 E Easy Street 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$2500 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:1299 SW Biltmore Street 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 inspecti n. If y u intend to obtain financing, ult with lender or an torney before
com ri 'n work or cordi our Notice of Commence ent.
Signa ure of Own r/ essee/Contrac as Agent for Owner Signature of Contr t r/License Ider
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF _tea LIIS�c. COUNTY OF 5
The forgoing instrument was acknowledged before me The fofgDing instrument was acknowledged before me
this 4 day of "*v-vl']Q41 2QZ by this day of D2f 91,�Y 20�7 by
Name of person making statement Name of person making statement
Personally Known X OR Produced Identification Personally Known ;K OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Sign1t,uZe of Notary Public-S to of FI ida J (Signa u\re of Notary Public-State ri
�"� ALEXANDERAG I
Commission N ;'<:?iYae; ALEXANDERI( IJAE Commission N �18 )
MY COMMISSION#GG 234811 =*: ;* OMMISSION#GG 234811
EXPIRES:July 4,2022
o EXPIRES:July 4,2022 ='?Fo oe° Y
Bonded Th
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17