HomeMy WebLinkAboutPermit ApplicationAll APPLICABLE IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: UO Nlauol Permit Number:
D Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 4330 N A1A, Fort Pierce, FL 32949
Property Tax ID #: 1423-565-0000-000-8
Site Plan Name:
Project Name: Altamira Condo Reroof BI
1
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: I
Reroof per Contract -
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New Electrical Meter Second Electrical
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 _Generator Roof Pitch
Total Sq. Ft of Construction: I' I d Sq. Ft. of First Floor:
Cost of Construction: $ (75`t `i 1_( d-A Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Altamira At North Hutchinson Island Condominium Association, Inc
Address: 835 20th PL
Name: Edward Campany
Company: Campany Roof Maintenance, Roofing Division, LLC
Address: 917 28th Street
City: Vero Beach State: _
Zip Code: 32960 Fax:
Phone No. -99C3
City: West Palm Beach State: FL
Zip Code: 33407 Fax:
Phone No561-863-6550
E-Mail:n-CO].()M •eiliOW-rt-nll. Cr/'Yi'I
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Permitting@campanyroofing.com
State or County License CCC 1330613
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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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
with lender or an attornev before commencing work or recording vour Notice of Commencement.
Signature of wner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License
STATE OF FLORID ^
STATE OF FLO
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COUNTY OF A��U CYO
Sit 0 0 (or affirmed) and subscribed before me of
Swor to (or affirmed) and subscribed before me of
_ Physical Presence or Online Notarization
Ph ical Presence or Online Notarization
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this day of 2020 by
this ay of 2024
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Name of persoh making statement.
Name of person making st ment.
Personally Known 1// OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
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