HomeMy WebLinkAboutBuilding Permit App All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:Roof Repair
Address: 7005 Paso Robles Blvd
Property Tax ID#: 1301-611-0106-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Remove and replace 510 sq ft of shingles at the rear of roof only
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator 'A�Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ $4000.00 Utilities: —Sewer _Septic Building Height:
Name Rakeva Wilson Name:Rene Reyes
Address:7005 Paso Robles Blvd Company:My Flrorida Roofing Contractor
City: Fort Pierce State: c- Address:1140 17th place
Zip Code: 32951 Fax: City: Vero Beach State:FI
Phone No. Zip Code: 32960 Fax:
E-Mail: Phone N0772-453-7219
Fill in fee simple Title Holder on next page(if different E-Mailcs@myflroofingcontractor.com
from the Owner listed above) State or County License CCC1326546
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
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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 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signatu a of Contra ctor/Licerife Holder
STATE OF FLORIDA STATE OF FLORInAr-
COUNTY OF COUNTY OF 0-A
Sworn to(or affirmed)and subscribed before me of Stan to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization �`' Physical Presence or Online Notarization
this day of 2020 by this o day of C_. 2020 by
Name of person making statement. Name of person making stater4ent.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Io 'da )
Commission No. (Seal) Commission No. ` Qk' `I `) (Seal)
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DATE
RECEIVED
DATE
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