HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03-01-2021 Permit Number:
1�1'o [Luce
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
L
ERMIT APPLICATION FOR:Reroof
ROPOSED IMPROVEMENT LOCATION:
Address: 4809 Buchanan Drive
Property Tax ID #: 3402-605-0132-000-4
Site Plan Name: Frederick
Project Name: Frederick
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential x
Lot No. 18
Block No. 38
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters — windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof 6/12 Pitch
Total Sq. Ft of Construction: 2100 Sq. Ft. of First Floor: 2100
Cost of Construction: $ 16700 Utilities: _ Sewer _ Septic Building Height: 20
OWNER/LESSEE:
CONTRACTOR:
Name Thomas Frederick
Name: Richard Colletti
Address:4809 Buchanan Drive
Company: Leakbusters Roof Repair
City: Fort Pierce FL State: —
Zip Code: 34982 Fax:
Phone No. 7725281635
Address: 6101 Buchanan Drive
City: Fort Pierce FL
State:
Zip Code: 34982 Fax:
Phone No 7723328450
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
If value of construction is 7snn nr mnra � Qtrnoncn .i_a:__
E-Mail richiecolletti@gmail.com
State or County License 29763
- --- -- ----•- cuccncn� IJ ICl MMU.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: — 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.
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite befor st inspection. If you intend to obtain financing, consult
with lender r at rn of re comrrxen work r recordin our Notice of Commencement.
Signature o ner/ Lessee/Contractor as Agent for Owner Signature of Contractor/Lice Holder
STATE OF FL
COUNTY OFORIDA COUNTY OSTATE OF FLORIDF_
I�Ik__7
Sw n to (or affirmed) and subscribed before me of
Physical Preserice or Online Notarization
this day off�? 2020 by
�lP (%> Firrim
Name of person making statement.
Personally Known —�/ stOR Produced Identification
Type of Identification
Produced
i ure_9fXotary Public- State of FOO E hlAVEN_S
My COMMISSION #GG165030
Commission No. EXP➢F&*04 2027
f OnaW through 1st State insurance
REVIEWS I FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Swor to (or affirmed) and subscribed before me of
hysical Pr, s ce or Online Notarization
t is day of ,y 2020 by
Name of person making statement.
Personally Known A OR Produced Identification
Type of Identification
Produced
(Signature o �aryyubf ic- State of.ELarLdA_ a
Commission No. 2aAYP`�` KATHERINEHiy;_,
F ���OPv1MISSION i`GG1i7�i
'��^'-� � EXFiRES: DEC 04, 2C327
SUPERVISOR PLANS I VEGETATION I SEA TURTLE ]_MiAN_GR6
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