HomeMy WebLinkAboutBUILDING PERMITAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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o�*k_7 Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:RE-ROOF
Address: !1 d� ?_PW 0M
Property Tax ID #: 4511-503-0022-000-5
Site Plan Name:
Project Name: GERTRUDE HAESELIN
REMOVE EXISTING TILE ROOF
APPLY POLYSTICK TU-MAX DIRECT TO DECK
INSTALL BORAL LIFETIME TILE ROOF SYSTEM
New Electrical Meter
Second Electrical Meter
A:-L 3 0 Q
Additional work to be performed under this permit— check all that apply:
Mechanical _ Gas Tank —Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: 25sq Sq. Ft. of First Floor:
Cost of Construction: $ 26,250
NameGeertrude Haeselin
Address:103 Pepper) Lane
City: Jensen Beach State:
Zip Code: 34957 Fax:
Phone No.631-935-4151
E-Mail:
Lot No.16
Block No.
Windows/Doors _ Pond
Roof 5/12 Pitch
Utilities: —Sewer —Septic Building Height:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name:Joshua Schroeder
Company: Marzo Roofing Inc
Address:861 Sw Lakehurst drive
City: port saint lucie State:fl
Zip Code: 34983 Fax:
Phone No772-871-2489
E-Mail marzoroofinginc@gmail.com
State or County License CCC1 331207
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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MORTGAGE COMPANY:
_ Not Applicable
DESIGNER/ENGINEER: _ Not Applicable.
Name:
Name:
Address:
Address:
City:
State:
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.
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 before the first inspection. If you intend to obtain financing, consult
wi+h Innrlar nr on ��.r,�nav hafnra rnmmanrina wnrk nr rarnrdinzz vnurAhtKiEla of Commencement.
Signature o Owner/ Lessee/Contractor as Agent for Owner
Signatur Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFsLC
COUNTY OFsLC
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
x Physical Presence or Online Notarization
this 15 day of MARCH 12026 by
this 15 day of MARCH , 2021 by
Name of person making statement.
Name of person making statement.
OR Produced Identification x
Personally Kn wn OR Produced Identification x
ic�tion
Type of Identl Icati n
SE
Produced LICEN E
*naKnwn
Kenrry Harrzow
I Public
otary PublicT�emm
(Signature o try Publi f�{ Florida
Florida
o. St�teQfdifflF HN087667
Commq HH087667
Commission No. `�Ne t9�� �)1/2025
1gExpires 2/1/2025
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Kev. 516126