HomeMy WebLinkAboutBuilding Permit Application - 3401 Cortez blvd Main homeAll APPILI CA13LE INFO MUST B E COM PLETED FOR APPLICATION TO BE ACC EPTIED
DatL.; 1-12-2021
ftnMno and J)ewfoPmen r 5ervkes
Permit Number:
Building permit Application
64oi fq Enid Code Regufation DNfs�3rr Commercial Re5ideTi al
2300 Virgonro Avenue, fort Pierce F4
Phon-e; (772) 462-1553 Fax: [772� 462-1579
PERMIT APPLICATION FOR, RE ROOF MAIN HOME
PROMS IMPROVEMENT LOCATI0N:
A4 d res5: 3Q1 GORTEZ BLV D
Property Tax I R lt; 2420-311-0004-000-9
Slte Parr Nm:
Prajert Name:
DETAILED DESCRI PTION DF WORX:
REMOVE HIN'GI.-E ROOF
INSTALL PEEL & STICK UNDERLAYMENT FL16048
IINSTALL 5V METAL FL17022
New E Iectrica I Meter Second Eledriral Meter
CONSTRUCTION I NFORMATIDN:
Additional work to he performed under this permit —cheek all that a ppdy;
_.Mecha n ical _ Gas Ta n k —Gas Piping
_ Electric Plum I�i-nq _ Sprinklers
iota I SQ. Ft of Construction- a,009
Cost Df Construction: 5 Lt.. 050
OWNER/LESSEE:
N ame Cynthia Mead s
Address: 3401 Cortez BLV D _
City: FORT PIERCE Srate:
Zip Code: 34981
Lot No.
BI(Kk NO.
_ Shutt rs _ Wind(w5 f 13wr:5 _ _ Pond
_ Generator _XROaf :5112 Pitch
5q_ Ft. of first Flppr_ 31009
Utl Iktles; —Sewer _ 5eprie
Fax: — —
Phone N.G.
F ill in fee simple Trtle Holde r on next p2ge ( if d iffere nt
from the ownL%r lid a6nve)
CON TRA C rOR:
B u ildi.ng H e-ight: 8 FT
Name: ROLAND WILEY
Corn parry; SHORIEL I N E ROOFING
Address; 1973 SW GLENDALE STREET
City_ PORT 9T LU DIE sta re_ FL
Zip Code: 34987 Fax:
Rhone No 772-2I -8 5
E-Ma ill SHORELINEROOF ING @ YAHOO.GOM
State or Cou n#y License CCC 1331170
If value of uonM4;tivn is 25M yr more, a RECORD E D Notice of Commenceme nt Is F ecruired.
If value of HAVC is $7, SHOD or more, a RE [ORDE D Notice of Commencement is req uirtLi,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION -
DESIGN WENGIN EERY _ Nit Applicable
Name..
Ad dress:
City; _-- State.
Zip.. Phone
FEE SIMPLE TITLE HOLD ER! _ Not Applicable
Name
Address;
Cl ty:
Zip;
MORTGAGE COM P ANY:
_ Not Ap plicabl e '
Name:
City;
State:
Zip, Phone:
BOND ING COMPANY-
_N Cit Appl I -Cable J
Name:
A,dtl ress;
City_
Zip; phone'
OWN E R/ CONTRACTOR AF F I DVIT. Applicatieim is hereby miadk t%o obtaln a perml# to do the work and install3bun as indicated.
I certify t#tiat no work or m5tallation has cornmenced prior To the is&uariee & a pefmit.
St. Laxie C�un makes no reprew ntAicr1 that is gtanti ng a permi.t wirl authorize th ermit holdrr to buil<1 the suk JjKt structure
which i s 1+1 t wG#h any applicable Home Owners Association rule§, Waws arr Covenants that may restrict or prohibit Su[ I.
structure. P ease consult �Ch y�r Home Owners Association and rem eww your r ed or any re5trwtions which may apply.
In consideration of the granFing -of this fequested perm ik� I do hereby aigree [h&k I will, i n .11 ieWects, perform the work
in accrordanm with. the approved plarNs, the Florida Building Codes and St, Lucie C4uMv Ame"merds..
The followi mg bui1¢ing pefmft applications are exem pt from undeFpi ng .a fu II concvrwrV review: rciom additions,
Kcessory structures, swimming OoNs, fences, wa 11:5,, ugns, screen roams and accessory us@s to another rion-ievdential use
WARN ING TO OWN E R: You r fa Ilure to R rd a Notice of Commeintement maV resutt In pone twke far
improvem eats to your property- A Notice of Comme rkee anent rn ust be recorded in the pu blic record 6 of St -
Lucie County -a nd posted or1 t h e j obsi to h-afora the first ir1 spection- kf you ir7ternd to obte I n fl nanci ng, con cult
with reads r or an attorney tief0re com m-artici ng work or recording your Ncitice of Com m encement.
signature raf Owner] Lessee}Contrkctor a 5 AEer`t for Owner
Signature of Contractor{Lic-ense Hol
STATE OF FLORI I STATE OF FLORIDA
COUNTY OF a CO U NTY OF
Zp
to far af'firmud } ir`d sabKnl �d before me of
hyrsi-cal Presence pr Online Numrizaticm
this — day of . W2D bV
5w to rqr -affirmed) and subscribed before me of
_ PhygiCaL Presence or Online N otarization
this da'! of . Z020 by
2):j a2vj- L [et —
Name *f person rm iWng $10 Imo - Name of person making statemenliff
Personally �Crl wrl - R Rr duoe�d Id ntiflca Per5cknally Known DR Praducrd ItyrrFtiii4 #i
Type of I dentificadon Type of 'Identification g
P uced W prucd s
[Signature of ry Public- Srate qF Fl-crida } {, (signature of public- State of Florida 1 4
e
Cam mission No. [5e811j t Commission No.
[Seal l
i
FLEVIEWS FRO NT ZDN I PIG SU P EFRVISO R P LANs V EC ETATION SEA TU RTLE MANGROVE
C:DRJNTER ° 'REVIEW -REVIEW I REVIEW REWEW REVIEW REVIEW
P LETED