HomeMy WebLinkAboutPermit Appl for 6820 Dickinson TerrAll 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: Roofing permit
PROPOSED IMPROVEMENT LOCATION:
Address: 6820 Dickinson TERPort Saint Lucie, FL 34952
Property Tax ID #: 3415-706-0043-000-3
Site Plan Name: Piatkowski
Project Name: Piatkowski
DETAILED DESCRIPTION OF WORK:
Remove exting roof cover / nail existing deck to code
Install new uderlayment / tri-built / peel & Stick
Install new metal roof / 5V / 26 gauge
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
Electric _ Plumbing
Total Sq. Ft of Construction: 3,800
Cost of Construction: $ 18,200
_ Sprinklers
Generator Roof 5/12
Sq. Ft. of First Floor: 3,800
X
Lot No. 1
Block No. 3
Pond
Pitch
Utilities: —Sewer _Septic Building Height: 8'
OWNERAESSEE:
CONTRACTOR:
i
Name Christine M Piatkowski
Name: Mauricio Orellana
Address:6820 Dickinson TER
Company:One Construction & Roofing
City: Port Saint Lucie State: _
Zip Code: 34952 Fax:
Phone No.772-569-2225
Address: 2766 sw Edgarce st
City: Port Saint Lucie State: FI
Zip Code: 34953 Fax:
Phone No 772-240-9497
E-Mail:N/A
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail oneconstructionservices@yahoo.com
State or County License CCC-1330623
If value of construction is 2500 or more, a RECORDED Notice of commencement is requirea.
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 LDER: _ Not Applicable
BONDING COM NY: 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 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 �
COUNTY OF�.—
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
�--%hvsical Presence or Online Notarization
cal Presence or Online Notarization
this day of yc ate{ G 202q by
thisML-��'ay of' � �rv� G 202A by
Name of person making statement.
Name of person making statement.
Personally Known t---- OR Produced Identification
Personally Known L--° '-"' OR Produced Identification
Type of Identification
Type of Identification
Pro ced
Produced
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REVIEWS
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SUPERVISOR
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SEATURTLE
MANGROVE
COUNTER
REVIEW
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DATE
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DATE
COMPLETED
Rev. 5