HomeMy WebLinkAboutBuilding Permit Application 1
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED •�1 Date: 7 Permit Number: 1 / o (0
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Building Permit Application
Planning and Development Services APR 2.8 2017
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 8000 Plantation Lakes Dr.
Legal Description: Reserve Plantation Phase IIA,Lot 21
Property Tax ID#: 3321-803-0027-000-5 Lot No.21
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
,Re-roof Single Family Residence. Remove tile and install new tile roof. Install self adhering modified
bitumen base sheet and self adhering underlayment. `Vile.+0. b2 1-✓6,tCdled# L,0i"1L\
4-WO sUeWs Pev_+I E_,
CONSTRUCTION INFORMATION:
Additional workto e e orme under this permit—check a apply:
�HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric Plumbing []Sprinklers El Generator 11 Roof � / Roof pitch
Total Sq.Ft of Construction: 5000 S Ft.of First Floor:
Cost of Construction:$ 28600.00 Utilities:Cn Sewer E]Septic Building Height: 1
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OWNERAESSEE: CONTRACTOR:
Named Steinberger owdroE Name: David R.Packard
Address:8000 Plantation Lakes Dr. Company: Packard Roofing&Waterproofing, Inc.
F'ti
City: Port St.Lucie FL Address: 2182 NW Reserve Park Trace
Zip Code: 34986 Fax: City: Port St.Lucie State:FL
Phone No.772-468-3723 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: , Harf/-cX J5. ffne—k »fin Name:
Address: -, �, �) — Address:
City: ,- State:jtL City: State:
Zip: .2 Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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 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.
S r
Signature of Owner/Lessee/Contractor as Agent for Owner Signature o ontractor icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SY: W a P COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this �� ay of /.� 20 l�by this�rdd`ay of S► 20 by
(Name of person acknowledging) (Name of person acknowledging)
N
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known �OR Produced Identification Personally Known vl-**'OR Produced Identification
Type of Identification Type of IdentificaW"*'Z"F1,F"_10"%'
"'�• NIE P.SMITH S%HAWE P.SMITH
Commission No. =_,• �? Notar�ttglyc-State of Florida Commission No. NotaMy Comm.Expires Sep 2,2017 ' State of Florida
My Comm.Expires Sep 2,2017
� Commission#FF 050475"filisi, Bonded Through National Notary Assn.
Bonded Through National Notary Assn.
Revised 07/15/201
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DATE
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INITIALS /