HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l j
Date: Permit Number: 1�^+' �,"�
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- Building Permit Application qpR
Planning and Development Services ®1 �o�/
Building and Code Regulation Division g PERilll7TlftJG
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2300 Virginia Avenue,Fort Pierce FL 34982 Lucie
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential 'Fes�_, FL
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: r
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Legal Description: 1
Property Tax ID#: �� M0( M - QC0-Y Lot No. I Z
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
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DETAILED DESCRIPTION OF WORK.
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We will tear off the existing roofing down to the plywood, Re-nail the deck to the current code and Re-roof.
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CONSTRUCTION INFORMATION: r=
Adclitional work to be performedd under this permit-check all apply:
�HVAC L__I Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 2-46o So. Ft.of First Floor: N/a
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Cost of Construction:$ F r rl �14 itTities: _Sewer E]Septic Building Height: N/a
OWNER/LESSEE: CONTRACTOR: f .
Name Name: Christopher Collins
Address: ' Company: Collins Roofing Inc
City: i vA Lucj e 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: Collinsroofinginc@gmail.com
from the Owner listed above) State or County License: CCC-058011
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If value of construction is$2506 or more,a RECORDED Notice of Commencement is required.
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,SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.-
DESIGNER/ENGINEER: d_Not a MORTGAGE COMPANY: d Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zi Phone:
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FEE SIMPLE TITLEHOLDER: V Not _ BONDING COMPANY: Not A
Name: `gym g Name:
Address: , Address: r
City: City:
Zip: Phone: Zip Phone:
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I certify that no work or installation has commenced prior to the issuance of a permit.
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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 followi wilding pe it ap 'cations are xempt from undergoing a full con rency review. oo ions,
accesso structures,swi m' pools,fences, ails,signs,screen rooms and cessory uses to er non-re 'dential use
W NING TO OWN :Your failure to cord a Notice of Com encement ma esult your payi g twice for
Jefore
provements t r property.A No ce of Commencem t must be r orded a d poste the jobsite
the fir l eCtion. If you ' to d to obtain financ' g, consult w' r ran y before
mmenci or recordi ou Notice of Comme cement.
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gnature of Owner/Lessee/Agent r or/Lic older
STATE OF FLORID STATE OF FLORIDA
COUNTY OF c4e COUNTY OF 54- Z-,sc
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The forgoing instrtiment was acknowledged before me The forgoing instrument was acknowledged before me
this__7_day of 0 ' 20 17 by this/7 day of , 20 V 7 by
Q-1AV tf�*b'0 k� 1. t r%1f
(Name of person acknowledging) (Name of person acknowledging)
0_atl,�, C�, Z&24�_t_
(Signature ofQMt&y Public-State of Florida) (Signature 6 N ary Public-State of Florida)
Personally Known OR Produced Identification Personally Known &-"�OR Produced Identification
Type of Identification Produced .-� Q` Type of Identification Pro u d
����� ��.. �, CATHY J ROBERTS
Commission _ ° 2 '1�rry �cJ � `0 Florida Commission No. ° Ndta �bllc-State of Florida
commission#FF 221708 Commission#FF 221708
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0 "�` Bondedthrough National Notary Assn ��������" Bonded through National Notary Assn.
Revised OTk�l ( Y
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE j
INITIALS
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