HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Lk 'ot.� Permit Number: IG 14" d reZ 1
RECEI'.'-D APR ? g 2017
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 Residential Yes
PERMIT APPLICATION FOR: Roof pa FN;}
PROPOSED IMPROVEMENT LOCATION:
Address: TCZ0 6"erA,l!( AV e- -A, ''u i a �
Legal Description: L—n Ice\a`�(7j JDr-xf r_'_ — LA yA ' 5 ��
Property Tax ID#: Lot No.
Site Plan Name: N/a Block No.
Project Name: N/a
Setbacks Front N/a Back: N/a Right Side: N/a Left Side: N/a
DETAILED DESCRIPTION O'F'WORK:
We will tear off the existing roofing down to the plywood, Re-nail the deck to the current code and Re-roof.
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CONSTRUCTION INFORMATION:
Additional wor to e performed under this permit—check a apply:
E1HVAC E]Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing OSprinklers Generator Roof
Total Sq. Ft of Construction: �'II.V S J n"71 llr S . Ft.of First Floor: N/a
Cost of Construction:$ 91,4-3 0 • I10 Utilities:Sewer ElSeptic Building Height: N/a
OWNER/LESSEE: �n CONTRACTOR:
Name H. hal + IS�t(, 1�1(7�Q� Name: Christopher Collins
Address:-1 Company: Collins Roofing Inc
City: .` to-r-cN. State: Address: PO Box 12867
Zip Code: 34�5 I Fax:N/a City: Fort Pierce State:FL
Phone No.N/a Zip Code: 34979 Fax: 772-489-6505
E-Mail:N/a Phone No. 772-201-1352 or 772940-8607
Fill in fee simple Title Holder on next page(if different E-Mail: Collinsroofinginc@gmail.com
from the Owner listed above) State or County License: CCC-058011
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: d_Not Applicable MORTGAGE COMPANY: d p icable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip Phone:
FEE SIMPLE TITLE HOLDER: d Not A BONDING COMPANY: pplicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
1 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 a Florida Building Codes and St.Lucie County Amendm
The folio • g buildin a it applications are exempt from undergoing a full c urrency v w:room ad)-residen
access structures imming pools,fe ces,walls,signs,screen rooms a accessory ses t another nol use
W NING TO W ER:Your failu a to Record a Notice of Co menceme may suit in youricefor
i proveme st ourprop y A Notice of Commence ent must b re,c r 'd and post jobsite
fore th i spectio f u intend to obtain fina cing, consult t1� I der or an ore
commen r or or i g your Notice of Comm ncement.
s
Lire of O r/Lessee/Agent Sign a of Contract ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF I�,L IU COUNTY OFF-I tic If
The for oing instr ent as acknowledged efore me The forgoing instrument wa acknowledged before me
this day o 20( by this 4 day of 20 by
](Na ,oTfperson acknowled g) Na o perscth ackn ledg• g)
/(Signat fNolari Public-State of Florida) ( tgnat a to ublic- tate of Florida)
PersonallyKnown R ro Lice Personally Known ,�k i; Produced3Ir IfiE5tW
,� �a��,, n�`�����eR y j—r,— �o..
Type of Identification a �cd _ Type of Identification F Q a Notary Public-State of Florida `l
c = •c My Comm.Expires Dec 1,2017
- My Comm.Expires Gec 1,2017 -• -
Commission No. �c Commission N . �; Commi Sigal` FF 069924
Commp..N)# FF 069924
",OF.` ° Bonded Through National Notary Assn. '"'��� "� Bonded Through National Notary Assn.
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
COMPLETE
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