HomeMy WebLinkAboutBuilding permit applicationAll 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 Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
r�
a
Address:)) (,L 3I Jd; ,lent? � f_- re 1ch FL- 39S-S t
Property Tax ID #: (450L-_,So ( - 134 --T-UCH - L Lot No.
Site Plan Name:
Block No.
Project Name: GGn6e4n1!
V
DETAILED DESCRIPTION OF WORK:
2e►m, c. �' ></nL5irum 1510qrcx� F (Yit, per-►' aG r� clI r 2 r�Ci.� I Po C�( /�
SA I ,t'Yl o'-10 U'fM_D r).L-- It 1 `I � �%� wl i v1 n : z%ef 1,V1 . van J1 l rrl
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New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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 Roof Pitch
Total Sq. Ft of Construction: l eJ G� Sq. Ft. of First Floor:
Cost of Construction: $ �(� W Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name lZwLiLt f L NCB e *7
Name: Douglas E. Roe
Address: ( )W /\,Je•-I- I !� A. JCA
City: -Ta-ft-'Cr) ICtcV1 State: F't-
Zip Code: 3CIT Fax:
Phone No.
Company: Code Red Roofers, Inc
Address: 3341 SE Slater St
City: Stuart State: FL
Zip Code: 34997 Fax:
Phone No 772-287-2829
E-Mail: V 4ne-4-) ic-5 61 e,qaywo . LCy`<-
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail permits 9 codered roofers. com
State or County License CCC1325674
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.
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:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a to do the work installation
permit and 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
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 11)fAil-f Iv',
COUNTY OF Lna#,4 w-1
Sn to (or affirmed) and subscribed before me of
YPhysical
Swprn to (or affirmed) and subscribed before me of
l/'
Presence or Online Notarization
Physical Presence or Online Notarization
this l day of E)P E rune_ 2020 by
this 2L day of 2020 by
" Id 1%Us2,a,�jh 4
`r _1 I cis L, le<_
Name of person making statement.
Name of pe on makin tatement.
Personally Known OR Produced Identification `��
Personally Known \/ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida
PUB(i AYNAJ. REGIS
(Signature of otary Public- State o �p rlda )
PDeDAYNAJ. REGIS
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Commission No. I`iU53�, * !on # HH 053320
o pare October14.2024
tipAT
Commission No.i {I Ili, 33Z U * S mission # HH 053320
�`( res Oclnber 14, 2024
Tf OF F�,OF Bonded T1YU Budget IiDYdly Swims9rf
f
OF F`OA` Bonded itvu Bud9d Notary
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