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HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
L uMLIL
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
PROPOSED IMPROVEMENT LOCATION:
Address:
D 1 L
x
Property Tax ID q: _-.5-4o - C.A 09 -- Cr14)2 S 7 -I _ Lot No..Z] 4-2�i
Site Plan Name: NIA Block No. 54
Project Name: _rF,) r_-:5(7 I 11 Y r T
DETAILED DESCRIPTION OF WORK,
u
r2 -ew
New Electrical Meter NIA Second Electrical
CONSTRUCTION INFORMATION: i
Additional work to be performed under this permit -check all that apply.
Mechanical _ Gas Tank , Gas Piping _ Shutters ___- Windows/Doors Pond
Electric _ Plumbing rr ff''-- _AS�prinkle �s--j T Generator _Roof
Total Sq. Ft of Construction: 33 `-& !Yi a I Fla_ Sq. Ft. of First Floor: NIA
Cost of Construction: $ L5_0 3M -w Utilities: —Sewer —Septic
12 Pitch
z/ z
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
—_— _____
Name: Christopher Collins
Address:
Company:Colhns Roofing Inc
City: State: ,
Address: PO Box 12867
City: Fort Pierce State: FL
Zip Code: Fax:
Phone No.
Zip Code: 34979 Fax: NIA
E-Mail: &Z
Phone No 772-940-8607
E-Mail collmsroofinginc@gmaii.com
Fill In fee slm a Title Holder on next page (if different
State or County License CCC-05B011
from the Owner listed above)
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 CONSTRUCTi©N LIEN LAW INFORMATION
©ESIG—NE R/ENGIlVEER. hi Ap Ica
ip
Address:
City: State
7�..ip Phone
FETE SIMPLE TITLE HOLDER: x Not
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not A g__._.
Name: --
Address:
City: State
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
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 permm lications are exempt from undergoing a full conasrren ew: room additions,
accessory structur swimming p o 49"tes, walls, igns, screen rooms and accce uses to nother aa-ses ntial use
WARNING OWNER failure to Reco a Notice of Comme meat mazy re in paying twice
impr ements t oupproperty. A Nice of Commence nt must be r grded4rrt,he public tecords of St.
Lu a Coun d pp edyp the jo Ite before the first ipfspection. If y intepd to obtain financing, consult
ith tend r a oFne befo commencing work of records v r DxAtite of Commerl¢�ment.
n er/ as Agent for Owner
C tractor License Holder
leJContractor
STATE OF FLORIDAz f
STATE OF FLORIDA
COUNTY OF `��{ (t, /-
�
COUNTY OF
Swgm to (or affirmed) and subscribed before me of
al Pre ce or Online No rization
Swor o for affirmed) and subscribed before me of
steal Pr ce or Online No nzation
of fly
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4Np'crson
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making statement
Name of person making statement.
Personally Knowlk OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signatur at 2= Florida I
Commission r ""'x ' 8ELINDA DARDEIjSeal)
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REVIEWS
UPERVISOR
PLANS VEGETATION
S A R L
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 516/20