HomeMy WebLinkAboutReroof Permit Application - 5692 Travelers WayA AI i4PPLKABLE INFO MUST P E CDM PLETE D FOR APPLICATION TO BE ACCEPTED
Daw. 1-21-2021
Permit fJ umber,
8tillding Permit Application
Pinnn n!y 12rid Dev4?Jopment 5ervr[es
Buridin g and Code Rgwh7tian OMsiM Corn me rC I a I _ Re!Od e n tia M
23W VirgWo Avc"up, 6ort Prerre Ft 34982
Phone: (772I 452-155� Fax; I7727 4$2-1579
PERMIT APPLICATION FOR. R-E lR F -
y
' PROPOSED IMPROVEMENT LOCATION:
Address: 5692 Travelers VVAY
P ra petty Tax ID 0:
5i#e Plan Name:
Project Name.
341 0-503-0068-D00-3
DETAILED DESCRIPTION OF WORK:
REMOVE SHINGLES
INSTALL PEEL & STICK FL2569
INSTALL SHINGLE FL10674
Lot No. 13
Blk No.
INSTALL RID3EVENT NOA 19-7:277
NL-w El-eetri cAl Meter . _ Second Electrical Meter _--
CONSTRUCTION INFORMATION:
Additional work to be performed under this peKmit -{heck all that apply;
Mechanical Gas Tank _ Gas Piping
Electric Plumbing _ Sprink Iers
Total Sq. Ft -of ConS=Ctiori: 1.
Cat of corrstruc ion; $ 8600_
OWN ER/LESSEE:
Shutters I lows/Daa rs Pona
Senera#er poof 4112 T Pi tch
Sq. Ft- of First Floor: 1 ,2
U#ilMEA: —Sewer 5epti c BlAd ing Nei,�ht= aft
N am-e Cyntli id Anri Peyton
Address_ 5692 Travelers WAY
City: FoART FIE R U E
ZIP Code: Fax,.
Phone No,
E-Mail: CAPEYTON53GIVIAI L-CONI
Fill in Fee simple Title lloWer cm next page ( if d fererrt
from t1he Owner listed above)
CONIRACTOR:
Name; HOLAND WIiEY
compa ny: SHORE LI N E R DOFING
Address_ 1 973 �W ALE N DALE 6TR E ET -
City;PC RT ST L UO I E Sate; FL
Zip Cody: 34987 Fax-
Phone NO 77:2-2W-111 �5
E-Mai l S HORE_ LINE ROOFI N G'i YAHOO. COM
State or County Lice nse OO 1331170
IF value of Eons'tru-ctlon Is 2500 or more, a RECORDED N011ce of Commencement Is requk d,
If wi lue of HAVE: is �7,500 or MOM, a R EC41RDE D Notice of Ummencement is r" uired.
U PPLEMENTAL CCNSTRUCTI0N LIEN LAW INFOR MATI0N'
DESIGN
Name
Address_
VEER: —Not Applica
City. State: _
ZJ p: _... phone
FIEF SIM PtrE TITLE HOLDER: _ Not App I iica foie —
Name
Add r8ss:�-- --
City:
zip. _ Phone:
MORTGAGE COMPANY: _ Not Applicable
Name ---
Address;
City: -5#ate;
Zip: PF one;
BONDING CO M-PAN Y; :Not Applicable
Name:
Address-
C ityr-
zip: Phgne:
OWN E R/ C ONTRACTOR AF Fl DVIT: Apoicab-orw is hetaby made to obtain a permit to dQ the work and installation as i nd hated_
I rurtifw that no work ur i nstailation has cammerrced pwi*r r* tht issuance of a permit.
51. Lucid Cburlmake} no representation that is granting a permit will e�h�prite the permit holder to build the Subject structure
which is in ran�ict with anyppricaEle Home Owners Assn€cation rules, bylaws or and cavenpres that mayr r krlct or prohibit 5LBcK
structure_ 14ease wns�1t of your Home Owners Association and review your deed far aoyr res#r1v#I-ork� which maryr apply.
I n consideration of the granting Qf this r-epue 5ted permit, I do hereby agree that I wile, in alt respect, perform~ the wN k
i n accordance with the approsred pla ns, the FI orida building Codes a nd St_ Luce Cciunty Amendments.
The fall oaring bulldlrng permit applicaCer18 are emempt frflrn undergoing a full concurrency review_ room pddi#i-on$,
R tMory structures} swimming pucAs, ferKe5r walk, signs, screen room 5 and accessory uses to an other nan-residential use
WAR N ING TO OW N ER: You r fa du re to RecorOi a Notice of Commencement may result Irl paying twine for
improvem ernt s to your prop erty. A Not ice of Com me nice m-ent m List be reCor(le d in t he pu blic -record s of St,
Lucie County a nd post-ed on the j obsi le h efore t he fir,# in Specl�o n, I f you i ntend to obta i n fi nand ng, cons Lilt
ith fen de r or an atto rn before co m rn-epic i ni work o r rec�ordi n our Natic� of Cam m n�em ant.
. � 11 Aj
Signature ofOwner/ Lessee r rtit for Owner Signature of Cantractor�L ease Hal
STAVE O F FLO R I DA I STATE OF FLORID,'
COUNTY OF COUNTY DELuw
5wo to [or aftirrnea} and subscribed before me of
'j ital Prey ce or Online N a n nation
t is day of 202 by
Name of person ma7-011
errt. n
Perspnellyr Known ..__ Produced Iderrdficatl rO'
Type of Identification
Produced
f Slgri-Zitu re of No y ublir- 5ta#e at F1wida j
r�Cfir1i misa+a•go I Seal) *� . `�`
REVIEWS rRONT
COUNTER
DATE
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,M PL
Swpr o (� ifirmed).ad }ub�cribed before m-eof
el Pre ce or Online N arization
tf1i d 04 L -- X42by
N41me of person Miking star ,er't, 3
Pcraonal ly Known OR Froduced tdentrfl€at
Type of Identification t
Produced g
r IL
Ignature of N t Public- mare of Plgrids } �
Commission No.23C3 �Se81 f
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