HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: a-k 1 3��
RECEIVED
JA N 2 0 2021
N f ` Permitting D
Y ° Building Permit Application St, Lucie Count epartma"t
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:REROOF- �-�.
PROPOSED IMPROVEMENT LOCATION:
Address: 3305 CORTEZ BLVD. FORT PIERCE,FL. 343980
Property Tax ID#: 2420-311-0004-010-2 Lot No.
Site Plan Name: 20 35-40 E85FT OF W185 OF E40OFT OFN204FT OF NE1/4SW Block No.
Project Name: BACK HOUSE
DETAILED DESCRIPTION OF WORK:
TEAR OFF OLD SHINGLE AND INSTALL 5V-METALS Q
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 _Win ows/Doors Pond
Electric _Plumbing _Sprinklers —Generator Roof Y Pitch
Total Sq. Ft of Construction: 600 Sq. Ft. of First Floor: 600
Cost of Construction:$ 4000. Utilities: —Sewer _Septic Building Height: 8
OWNER/LESSEE: CONTRACTOR:
Name JAMES PURNEL Name:JOHN G CANNON
Address:3305 CORTEZ BLVD Company:JOHN G CANNON
City: FORT PIERCE State:_ Address:7901 CITRUS PARK BLVD
Zip Code: 34981 Fax: City: FORT PIERCE State: FL
Phone No.772-209-0532 Zip Code: 34951 Fax: 772-468-0272
E-Mail: Phone No CELL 772-201-1771
Fill in fee simple Title Holder on next page(if different E-mail JGCAN NON ROOF@ ICLOUD.COM
from the Owner listed above) State or County License CCC1330664
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.
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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 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 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 ender or an attorney before commencing work or recording our Notice of Commencement.
ignature f Owner/Lessee/Contractor as Agent for Owner F452re Lod(CoiR—mcfarJLicense Holder
STATE OF FLORII?A STATE OF FLORIDA
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COUNTY OF , L4,)6 COUNTY OF
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this��day of 54yr, ,202q by this S4 day of 202& by
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Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identifica ' n Type of Identification
Produced `+ Produced `
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(Signature of Notary Public- tate of Florida) (Signature of Notary Public-State of Florida 1
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