HomeMy WebLinkAboutBuilding Permit applcationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
T. L C
�1
C T N"T�Y
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential X
PERMIT APPLICATION FOR: RE -ROOF
PROPOSED IMPRO\/EMENTLOC%�fION} X
Address: 5707 UNIVERSITY LANE FORT PIERCE FLORIDS 34951
Property Tax ID #: 1301-604-0124-130-6
Site Plan Name:
Project Name: CHRISTIAN JACOBSEN
REMOVE EXISTING SHINGLE ROOF
Lot No.
Block No. 32
APPLY POLYSTICK MTS DIRECT TO DECK / INSTALL 5V METAL GA GALVALUME METAL ROOF SYSTEM
APPLY POLYGLASS SAV DIRECT TO DECK APPLY SAP CAPSHEET (FLAT ROOF)
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping. Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 17700
Generator
Sq. Ft. of First Floor:
-Windows/Doors
Roof 2.5/12
Utilities: _Sewer Septic, Building Height:
Pond
Pitch
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Name CHRISTIAN JACOBSEN
Name:JOSHUA SCHROEDER
Address:5703 UNIVERSITY LANE
Company:MARZO ROOFING
City: fort pierce State:
Address:861 sw lakehurst drive
City: port saint lucie State:fl
Zip Code: 34951 Fax:
Phone No. 772-528-4503
Zip Code: 34983 Fax:
Phone N0772-871-2489 . r
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E=Mail
from the Owner listed above)
State or County License
If value of construction is 2500 or more, a KECUKDtu Notice or Commencement is requireu.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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S iPRLEM NTAL�C()iNSTR{l TA[0NXfEN LA►WINFOR`M/
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TION m
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
City: State:
Address:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ 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.
consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
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-r al use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may res part ying t '
improvements to yo rty. A Notice of Commencement must be orded in u records of St.
Lucie County a o d the jobsite before the first inspection ou inten t ' inancing, consult
with lende r an • or ev before commencine work or recor ' 2 vour N C m
e Contractor as Agent for Owner
Sig re of Owner/ L / g
ature of Contractor Licerise Holder
/
STATE OF FLORID
STATE OF
COUNTY OF
COUNTY OFORID� D
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Pres nce or Online Notarization
this ! D day of � u 2020 by
this da of � / 202f by
'30414, 12 -- . I � I
Name of person rdaking statement.
Name of person making statement.
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y
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identifica ion
l�✓1
Produced
Produited
IF
p1tY P(,
nature of Nota y, y�st, ° a
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(Signature of t� Iic�41��k�iabFiti�irida )
�Q My Commission GG 098837�op
Commission No. o Expires04/27(MI)
e` My Commission 2 098831
Expires 04/27/2021
Commission N (Seal
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