HomeMy WebLinkAboutBuilding Permit Application I
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/6/17 Permit Number: rz? l b<
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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: 6007 SUNSET BLVD FT PIERCE, FL 34982
Legal Description: INDIAN RIVER ESTATES-UNIT-08-BLK 70 LOTS 27 AND 28(MAP 34/11S)(OR 3794-1284; 3938-2019)
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Property Tax ID#: 3402-609-0669-000-9 Lot No.27,28
Site Plan Name: Block No. 70
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION OF WORK:
TEAR OFF EXISTING SHINGLE/FLAT ROOF AND INSTALL NEW SHINGLE/FLAT ROOF-S
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CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit—check all apply:
1]HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing ❑Sprinklers Generator Roof 4/12 Roof pitch
Total Sq. Ft of Construction: 2160 S Ft. of First Floor:
Cost of Construction:$ 9900 Utilities:Sewer Septic Building Height: 1 STORY
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OWNER/LESSEE: C NTRACTOR:
Name THONGKAMON JANLUANG ink CHARLES RICHARDS j
Address:6007 SUNSET BLVD Company: ALL AREA ROOFING
City: FT PIERCE State:FL Address: 3921 S US HWY 1 it
Zip Code: 34982 F,ax: City: FT PIERCE State:FL
Phone No.772-332-7643 Zip Code: 34982 Fax: 772-464-6600
E-Mail: Phone No. 772-464-6800
Fill in fee simple Title Holder on next page(if different E-Mail: JENNIFER@ALLAREAROOFING.COM
from the Owner listed above) State or County License: CCC1326177
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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:
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FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicabl
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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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 s'iuch
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.
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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 jobsitel
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
comm ipg work or recording ur NpTco of Commencement.
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ig ure of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The forgoing instru Ent was acknowledged before me The forgoing instrument was acknowledged before me
this�day of" 20by this `u day of ' 20 by
CHARLES RICHARDS CHARLES RICHARDS
(Name of person acknowledging) (Name of rson acknowledging)
(Signature of Notary Public-State of Florida) (Signature 4 Notary Public-State of Florida)
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Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced Type of Identification Produced
tr�rr�Commission No.
FAITHMASON Commission No. o :p��li
(SEFAiiMASON
* * MYCOMMISSION Y GO 003939 * o* MY COMMISSION#GO 003939
a e EXPIRES:June 20 2020 a EXPIRES:June 20 2020
;9'@ 04-M ThN 9udgel Notary_%mae of F�o� Bonded Tutu Budpet Notary BaMaee
Revised 07/15/2014
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REVIEWS FRONT 'ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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