HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED •� ���
Date: 4/20/2017 Permit Number:
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 El
PROPOSED IIVIPRO.VEMENT LOCATION: _,,
Address: 3101 S 24th Street, Fort Pierce, FL 34982
Legal Description: Edgewood Acres Blk 1 Lot 9
Property Tax ID#: 2428-603-0009-000-4 Lot No. 9
Site Plan Name: Block No. 1
Project Name: Thomas Medaj
Setbacks Front Back: Right Side: Left Side:
DETAILED DE5CRIPTION.OF WORK
Remove Shingle Roof down to plywood deck install Tuplus underlayment and 5V Crimp Metal Roofing
CONSTRUCTIC?N IN1=0RIVIATION
Additional wor to be performed under this permit—check all apply:
�HVAC Gas Tank Gas Piping _Shutters Windows/Doors
Electric ❑ PlumbingSprinklers Generator Roof 3�12 Roof pitch
Total Sq. Ft of Construction: 1,470 S . Ft.of First Floor:
Cost of Construction:$ 10,0 00." UtilitiesIn Sewer Septic Building Height:
OWNER/LESSEE .;CONTRACTOR.
Name Thomas Medaj Name: William Lasky Jr
Address: 5311 E Echo Pines Circle Company: Atlantic Roofing 11 Of Vero Beach Inc
City: Fort Pierce State: FL Address: 4020 43rd Avenue
Zip Code: 34951 Fax: p� City: Vero Beach State: FL
Phone No. Zip Code: 32960 Fax: 772-257-5740
E-Mai, Phone No. 772-492-8493
Fill in fee simple Title Holder on next page(if different E-Mail: wljatr@aol.com
from the Owner listed above) State or County License: Both
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CQNSTRUCTION L'IEN"LL 1' INFORMATION:;.
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY:, X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: x Not Applicable
Name: Thomas Medai Name:
Address: 5311 E Echo Pines Circle Address:
City: Fort Pierce,Florida City:
Zip: 34951 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 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 your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you in end to obtain financing, consult with lender or an attor, ey before
commencing work or recordi ur Notice of Commencement. i
/ ; S
Signature of Owner/Lessee/Contr o Vs Agent for Owner Signature of Contractor/License H• de
STATE OF FLORIDA STATE OF FLORIDA
COUNTY COUNTY OF ^ ^ �
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of Nf-I l 20 Lby this day of April 20 1-7 by
VQY1�G1�1�� �11h�1�rMAlr1 Danielle P Zimmerman
(Name of person acknowledging) (Name of person acknowledging)
y
(Signature of Notary Publ c- tate of Florida) (Signature of Notary Publickyate of Florida)
Personally Known X OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produl PH Tv e of Identification Produced
DANIELLE P. ZIMMER AN
° ,..a••,,;, DANIELLE P. ZIMME ]71
Commission No. `�`= (SgBy,mission a FF 525 gCo mIS510n NO. FF52536 _a� �$eabommission H FjF 52
`O M Commission Ex c•� My Commission Expires :, ,••; Y p
%''•°rr� 01 '•,`;°rr�,o•`' September 09, 2
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS