HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPT
Date- Permit Number:
. I
Building Permit Application
Planning and Development Services
Building and Code Regulation Divwon
23W Virginia Avenue,Fart Pierre Ft 349a2
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address. 316 Holly Ave.,PSL FL
Legal Description: River Perk-Unit 2- Ellk 19 Lot 21(Map 34f22N)
Property Tax ID#: 3419-510-0252-000-2 Lot No. 21
Site Plan Name: NIA Block No. 19
Project Name: NIA
Setbacks Front N/A Back: NIA _...__ .Rlght Side: NIA Left Side: NlA .
DETAILED DESCRIPTION OF WORK.
We will tear off the existing shingle roof down to the wood deck. We will nail off the wood deck to tht,
current code. Install a self-adhesive underlayment directly to the wood deck. Install new asphalt
dimensional shingles.
rCONSTRUCTION INFORMATION: -
Aaditional Work to b rine under s perm —check a app Y:
IDHVAC [Gas Tank ❑Gas Piping LJ Shutters ❑Windows/t?oorss
l,..J Electric Q Plumbing Sprinklers 11 Generator Racif wo tact'
Total Sq. Ft of Construction: 23 Sq So. Ft.of Flrst Floor: NIA
9,4 1500 Illilit, 'tiSvwe+r 5t' ,tic itu,lili,l lir, h[ \
Cast of Construction:$� ► t; r~
OWNER/LESSEE: CONTRACTOR.
Name- lfl&un Donald Calms&Kristin Retding,,r i .uiii- Nam,, t lu, .lollli,'i Collin,.
Address: 316 Holly Ave Company: �',+Ihtr•Jt,ntiiitl I�t,
City: Port SaintLUCle tis,,t�' I I Addicss: I' tt ttux t:'tlnl
Zip Code: 34952 Fix:. N/A €,sy I I Pit'Ity it
Phone No. NIA Zip Coll,' 1-0.0 400
E-Mail: NIA Phone No e'0 t
Fill In fee dimple Title Holder on next pages( If different I M,iil I
from the Owner listed above) «r County Ltt+°n.r t t 11' Ittsl t
If value of construction Is$25DO or more,a RLCORD[D Notlrr of commencement Is requirad.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:with—Donald Gaups&KnsW fteidmper Calms Name:
Address:316 HCMY Ave.,PSL t=L Address: als Hoag Ave
City: Pon saIm Luae State: City: FL Pwfm State:
Zip: Phone Zip: Phone.
FEE SIMPLE TITLE HOLDER; Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: P-0-Box 1286T 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 follawln t ding rmit applications are exempt from undergoing a full cone Cy rev :room additions,
accesso Factures,sw pools, ces,walls,signs,screen roams and essory uses to a non re ' ential use
W ING TO O R:Your failure Record a Notice of Com ncement m t in your payl twice for
i rovements r property.A N tice of Commencem must be and posted the jobsite
e ore the fi section. If int nd to obtain financi g,consult I r or an a before
commenci o e-c n a Notice of Comme ement
Sig u Owner ee/Contractor as Agent for Owner Si Factor Se Holder
STATE OF FLORID� STATE OF FLO QA
COUNTY OF wcr� COUNTY OF
The f Ding instrument was acknowledged before me The f going Instru ent was cknowledge before me
this day of 20 `Zby this GZ day of 20 by
Name 6f person m k nia g statement Name of pers n making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identificatio
Produced O(1 Produced XL—
(Signature of Notary Publi tate of Florid Rebekah Hoy (Signature of Notary Pub" State of Florida j
�❑ Hoy
Commission No. STATE NOTARY
FLO IDAmmission No ��Q NOTATARy pU
Comn GG29,11110 STATE OF FLOFIII
Ex 're 2 Conxnit
Expires 2/17/2 2
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.S/2/17