HomeMy WebLinkAboutBuilding Permit Application I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 09/01/2017 P_er;nit Number:
k `:• ;��1'Ta
1711
. SEP 1 J
Building Permit Application 20v
Planning.and Development Services PERiV11771
St. NG
Building and Code Regulation Division Lucie Co L
2300 Virginia Avenue,Fort Pierce FL 34982 u ty F
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Roof 17-711
PROPOSED IMPROVEMENT LOCATION:
Address: 7999 Plantation Lakes Dr.
Legal Description: Reserve Plantation Phase 11A Lot 52
Property Tax ID#: 3321-803-0056-000-7 Lot No.52
Site Plan Name: Block No.
Project.Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Tear off tile roof, renail plywood, apply 30#felt, Polyglass TU Max self adhering underlayment and
Entegra Estate S the with two galvanized screws. Hip and ridge to be installed with mortar.
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CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit—check a apply:
F]HVAC Ei Gas Tank Gas Piping _Shutters. Windows/Doors
Electric ❑Plumbing ❑Sprinklers El Generator Roof Roof pitch
Total Sq. Ft of Construction: 6900 S . Ft.of First Floor:
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Cost of Construction:$ 43,000.00 Utilities: _Sewer E]Septic Building Height: 1
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,OWNER/LESSEE: CONTRACTOR:
NameJames Ferguson Name: David Packard
7999 Plantation Lakes Dr. Packard Roofin &Waterproofing, Inc.
Address: Company: g � g,
City: Port St.Lucie State:FL Address: 2182 NW Reserve Park Trace
Zip Code: 34986 Fax: City: Port St.Lucie State:FL
Phone No.586-243-8282 Zip Code: 34986 Fax: 772-468-9978
E-Mail: Phone No. 772-468-3723
Fill in fee simple Title Holder on next page(if different E-Mail: ssmith@packardroofing.com
from the Owner listed above) State or County License: CCCA17517
If value of construction is$2500 or more,a RECORDED Notice of Commencement.is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: kNot 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 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 intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
(20 -2
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF SA&ga:f
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this J-day of_' 4p.J4e ,20 r Eby this e!7 day of 5,WWAA;a6V ,20 t 7 by
zb td JaC,� � ��irl:r�1ue-KGl�
Name of perso making statement Name of person}making statement
Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Not (Signature of Not IE P.SMITH
�,•�v'o�•% S EP IE P.SMITH ,`is"'",e''•.,
Commission No. +°• .`�: Notary Pu��a1ptate of Florida :'r°. .`�; Notary Pub l)) S to of.Florlda
Commission No. = ° Comm.ESep 2,2017
• .•; y Comm.Expires Sep 2,2017 e y
s ate= Commission V.FF 050475 9: P Commission#FF 050475
alional Not Assn: °F° °`��` Bonded Through National Notary Assn:REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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