HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE IN O MU T BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� —7 Permit Number:
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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: d" 5e uQN'r •I C t�� �L
Legal Description: La kP-WC)c 2af [_m a I
Property Tax ID#: 1 3n 1 r 6209 —0 2_W LD—l O Lot No.
Site Plan Name: N/a Block No. b
Project Name: N/a
Setbacks Front N/a Back: N/a Right Side: N/a Left Side: N/a
DETAILED DESCRIPTIONQ OF WORK:
We will tear off the existing roofing down to the plywood, Re-nail the deck to the current code and Re-roof-j�e_
[CONSTRUCTION INFORMATION:
Additional work to be Dertormed under this permit-check all apply:
11HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers El Generator Roof
Total Sq. Ft of Construction:45 0 S . Ft.of First Floor: N/a
Cost of Construction:$ 2 i- _ �� _ Utilities:Cn Sewer 0 Septic Building Height: N/a
OWN ER/LESSEE: CONTRACTOR:
Name + Name: Christopher Collins
� ft�r
Address: _ (� Company: Collins Roofing Inc
City: 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
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 TITLEHOLDER: V_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 our Home Owners Association and review your deed for any restrictions which may apply.
In consideration of t granting o this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance wi the approved lans,the Florida Building Codes and St.Lucie County Amendments.
The followi uilding permit ap ions a exempt from undergoing a full concur r w:ro iti ,
accesso tructures,swim pools,fence walls,signs,screen rooms and a ssory uses to they non-resi ential use
WA ING TO OW R: our fai o ecord a Notice of Comm cement may s It in your payi g twice for
im ovements ou prop y N tice of Commenceme must be re and post d n the jobsite
b ore the fi nsp ctio . f u i end to obtain financin , consult en er or a r ey before
ommenci or r or ur Notice of Commenc ment.
s
e Ow essee/Agent n e of C6Tftractbr7tr&ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S-I Ly c%e- COUNTY OFF" -+ 4 ac
The forgoing instr ent was acknowledged before me The forgoing instrument was acknowledged before me
this_'flay of 20 17 by this day of rnaai, 20 by
(Name of person acknowledging) (Name of person acknowledging)
&4& c)
(Signature o ry Public-State of Florida) (Sign atur o ota y Public-State of Florida)
Personally Known OR Produced Identification t"L DL Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission`rN
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Commission No,.a�•„adY P�,,,
y (Seal)
CATHYR CATHY J ROBERTS
Wild-
ReVi Commission#FF 221708
_• •: Commission#FF 221708
Ay Comm.Expires May 10,2019 's�r� o��a= My Comm.Expires May 10,2019
Bonded th h NO- � .tf
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DATE
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