HomeMy WebLinkAboutBuilding Permit Application A
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u u u
Dater oLl'► Permit Number:
5= -=- � RECEI'.'rD APR � `0 :117
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 Yes
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: , K, 'Fc rA- r (
Legal Description: L{() �-rm NE I d SE I rF5-N 61 rtn w `125 Ei tc, "Gh Ain Co
109 i t,-itA !N i5U -Py t�� iv 109 Mtn nf;/� r5c Pr jT!� (k"`,o
PropertyTaxlD#: �I-� ]`�� .)�I �''(X� —l�Cill��� Lot No.
Site Plan Name: N/a Block No.
Project Name: N/a
Setbacks Front N/a Back: N/a Right Side: N/a Left Side: N/a
i
`DETAILED DESCRIPTION OF WORK:
We will tear off the a 'sting roofing down to the plywood, Re-nail the deck to the current code and Re-roof.tN
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit-check all apply:
11HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric ❑Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: ?Z Sq. Ft.of First Floor: N/a
Cost of Construction:$ Utilities: Ll_Sewer 0 Septic Building Height: N/a
OWNERAESSEE: CONTRACTOR:
Name QhrLC"\I IcA' LA\i n 1.'��C .�.t'�� Name: Christopher Collins
Address: _1 O 1-1 LGL( {' U Company: Collins Roofing Inc j
City: : 91(,cc t% State: Address: PO Box 12867
Zip Code: ,'� Fax:N/a City: Fort Pierce State:FL
Phone No.N/a Zip Code: 34979 Fax: 772-489-6505
E-Mail:N/a Phone No. 772-201-1352 or 772940-8607
Fill in fee simple Title Holder on next page(if different E-Mail: C011insroofinginc@gmail.com
from the Owner listed above) State or County License: CCC-058011
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: d Not Applicable MORTGAGE COMPANY: d_Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: d_Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 t d pl , ' e Flori Building Codes and St.Lucie County Amendments.
The following i ding perm' p lications are exe t from undergoing a full conic
view:room a ,
accessory s uctures,sw' ming ools,fences,walls signs,screen rooms and ac sory uses anot non-reside ial use
WAR NG TO O E •Y ur failure to Reco d a Notice of Comme cement may r t in your paying ice for
I
mp ovements roperty.A tice of Commencemen ust be recor d and posted a jobsite
b ore the firs s ion. If in n o obtain financin consult wit er or an a ne efore
mmencin o r reco in r otice of Commenc ent.
s
gnature of Owner see/Agent Signa e o tractor/License Holder
STATE OF FLORIDA, STATE OF FLORIDA
COUNTY OF QS �, care COUNTY OF SI" �G
The forgoing instru ent was acknowledged before me The forgoing instrument was acknowledged before me
this�day of ✓'. 20 LD by this�day of & r• 20 Z by
I'r.. 1s31 �i�t �Nlr�;sr n/� 6 /1111111
(Name of persoh acknowledging) (Name of person acknowledging)
(Signature of Wolt6y Public-State of Florida) (Signature N tary Public-State of Florida)
Personally n wn OR Produced Identification`� Personally Known OR Produced I.entification
Type of Id , �- �A Type of Identificatril
U �, i61.0Z bl.AeW sajldx3•wwo0 AW ;�° orb• a`�; Notary Pt�6a tate of LK
Florlda-
Commissi Nl0 a ' S Commission No.
oC - a . Commission FF 22 7708
ePIU01A 10 elelS-all4nd�tie1oN "s;All
or,.� a -,�,�,F o���,• My Comm.Expires May 10,20191
...,,,,,.•.• BOOM 111ii-65gina ion ary ASSW,1
Revised 07/15/2014 LL�4
I
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW,
DATE
COMPLETE j
INITIALS i ICI
I I
i