HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
11:Wlc[L s.N
l' 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
I PROPOSED IMPROVEMENT LOCATION: I
Address:
Property Tax ID It: �>OZ� �D��� a �� Lot No }
Site Plan Name: NIA Block No. 5D
Project Name: �1 d xv) 'r
DETAILED DESCRIPTION OF WORK:
Z ( c� 5-v
New Electrical Meter NIA Second Electrical MeterN/A
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric — Plumbing _ Sprinklers
Total Sq. Ft of Construction: 1
_ Generator
Windows/Doors _ Pond
Roof `� I Z Pitch
Sq. Ft. of First Floor: NIA
Cost of Construction: $ Utilities:
Sewer _ Septic Building Height: f
OWNER/LESSEE:
CONTRACTOR:
Name r
Name: Christopher Collins
Address: ir Iv
City: State: 'FLL
Zip Code: Z Fax: N
Phone No. !� A
Company: Collins Roofing Inc.
Address: PO Box 12867
City: Fort Pierce State: FL
Zip Code: 34979 Fax. N/A
Phone No 772-940-8607
E-Mail: [,//A
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail collinsroofinginc@gmail com
State or County License CCC-058011
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
MORTGAGE COMPANY: x -Net*ppr1Ea-ble
Name.
Name: --� -
Address:
Address:
City: State,
City: State:
ZiP- Phone
_'�
I • — Phone:
FEE SIMPLE TITLE HOLDER: x N ppiit ablTe
Name:
Address: I
BONDING COMPANY: _ pp icable
Name:
Address:
City:
Z' Phone:
City:
Zip• Phone:
OWNER/ CONTRACTOR AFFIDVFT: 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 consuit 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 bui it applica re exempt from undergoing a full concur ew: room additions,
accessory s;Fue:tures swim 'ng pfialsi fence walls, signs, screen rooms and accessory uses to "other non -re ential use
WARNING TO OWNER:, our failure to cord a Notice of Commencement may res It In paying twit for
,.rmprovemener
Jar tb ur property. A otice of ComFkor
etnent must c ded in the (rub c records of St.
/ Lucie Coun nd,osted otrthe j site before theinspection. u i t d to obtain ' ancing, consult
with lendrJorari atornev befor commencinew reeordin o 'ce of Comm cement.
Si ner/ ` ontractor as Agent for Owner
n a actor nse Holder
STATE OF FLOR
STATE OF FLORIDA
COUNTY OF I�i
COUNTY OF
Swo to [or affrmedJ and subscribed before me of
w to jor affirmed) and subscribed before me of
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P sical Pres a pr Online Not iaation
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Name of perso making sta ent.
Name of person7makiatement.
Personally KnovOR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Pra uced
Produced
— bl-� — —(Signature
of Notary Public State of Florida J
(Signature of of p iia Sty
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