HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: LA
Z�Z� Permit Number:
[LCt- CEE
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce F134982
Phone: (772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:
Anna RA—;-L, r;...�.,
Address: •►w I rviai ian %all
Property Tax ID#: 2408-602-0016-000-1 Lot No.
Site Plan Name: Block No.
Project Name: Nehemie Dume
Re-Roof shingle and flat roof
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit.—check all that apply:
_Mechanical _Gas Tank —Gas Piping Shutters _Windows/Doors !Pond
Electric r Plumbing _Sprinklers _Generator ✓Roof _Pitch
Total Sq. Ft of Construction: 2200 Sq. Ft. of First Floor:
Cost of Construction: $ 12,175.00 Utilities: Sewer _Septic Building Height: �S
� yi' r:�� a.a.. h" .fi rti;
k b,� •�'
NameNehemie Dume Name:James Boatright
Address:1555 E 57th St. Company:All Phase Roofing, Inc
City: Brooklyn State: Address:3705 Shares Place
Zip Code: 11234 Fax: City: West Palm Beach State:FL
Phone No.917.747.2029 Zip Code: 33404 Fax:
E-Mail:rgdume@yahoo.com Phone No561.863.9596
Fill in fee simple Title Holder on next page(if different E-Mailjackie@southflroofing.com
from the Owner listed above) State or County License CCC1331229
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.
NA,
El
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: —Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: ____Not Applicable
Name: 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 our Notice of Commencement.
Sigi4rure of Owner/Lessee/Contractor as Agent for Owner Sig ime of Con ractor/License Holder
STATE OF FLOWPA, STATE OF FLORID
COUNTY OF kr,n ��_ COUNTY OF -Pao\ tPC _
S7n to(or affirmed)and subscribed before me of Sworp to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization ✓Physical Presence or Online Notarization
this QaL day of �1C'Jl�[('^� .200 bbY this�day of M oi dcK ,209 by
F 1t
Nehemie Dume James 130abight
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification °� Personally Known OR Produced Identification
Type of Identification Type of Identification
Produc L-,)L A Produce
(Signatur Notary Public-S Florida) (Signat tary Public-St
�akto ida
JacgWflneFernandet ,�acq�elineFemandeg
Corn 'ssi No.1AH904Z�� eagoma►.9HH061429 � I
" ," Expires:Jan 21,2023 Commis ion o. *'__ E
Bonded TMuAaron Nary '' BoratedTMulltlaON�,ary
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 6/20