HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential ###
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:RE-ROOF SHINGLE TO METAL
PROPOSED IMPROVEMENT LOCATION:
Address: 2744 AND 2750 NIAGARA AVE PORT PIERCE, FL 34946
Property Tax ID#: 1428-702-1120-000-6 Lot No.16,17,18
Site Plan Name: SAN LUCIE PLAZA Block No. 52
Project Name: RD98 LLC
DETAILED DESCRIPTION OF WORK:
RE-ROOF SHINGLE TO METAL
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors _ Pond
Electric Plumbing _Sprinklers _Generators; Roof 4112 Pitch
Total Sq. Ft of Construction: 2210 Sq. Ft. of First Floor: 2210
Cost of Construction: $ 13260 Utilities: —Sewer _Septic Building Height: 15,
OWNERAESSEE: CONTRACTOR:
Name RD98 LLC GREG ROSSLOW Name:EDWARD LECHNER
Address:2744 NIAGARA AVE Company:EDIFICIUM CONST. LLC
City: FORT PIERCE State: Address:1215 CASTAWAY BLVD
Zip Code: 34946 Fax: City: VERO BEACH State:FL
Phone No.772-216-7231 Zip Code: 32963 Fax:
E-Mail:N1A Phone N0772-643-4513
Fill in fee simple Title Holder on next page(if different E-Mail EDIFICIUMROOFING@GMAIL.COM
from the Owner listed above) State or County License CCC1 331308
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
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 I MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone — Zip:
FEE SIMPLE TITLE HOLDER: __ Not Applicable BONDING COMPANY: � Not Applicable
Name: E Name:
Address: Address:
City: € City:
Zip: Phone: I 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.
5t. 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 resWt 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
with lender or an attorney before commencing work or recordingyour Notice of Commencement.
Signature of Owner/Lessee/Contract�asAge`nt for Owner Signature of Contractor is ise Holder
STATE OF FLO&DA J STATE OF FLORIDA 1
COUNTY OF _ � .� - �C,l� COUNTY OF��.t±L_ w iLj 4 4'
Sworn to(or affirmed)and subscribed before me of Sworri_t or affirmed)and subscribed before me of
physical Presence or Online Notarization Physical Presence or Online Notarization
thi _�t day of 111 a y G� t 2021 by this�day of fL't r 1s t gj. .. 202 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known L__� OR Produced Identification
Type of Identification Type of Identification
Produced Produced
f C ' 010 6� 7 f x.J
Sr ature o Notar Public
� Y II�OdtiA�tYPLtBLIC {Signature of Notary P R�7`iIR}�4��1gLIC
+STATE OF FLORIDA �� '
Commission No, Cp��iC,G971143 Commission No, o _ -STATE OF FLORIDA
Expir@5r 311812Q24 43
Expires 311812{124
REVIEWS FRONT ZONING SUPERVISOR PLANS I VEGETATION I SEA TURTLE MANGROVE
COUNTER REVIEW j REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE i
COMPLETED
Rev.