HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number.
r�. LLB
Building Permit Application
Planning and Developmenr Set -vices
Building and Code Regulanon Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Re Roof
PROPOSED IMPROVEMENT LOCATION: T
--
Address: 5102 Palm Drive Ft Pierce, FL 34982
Property Tax ID d: 3402-608-0350-000-7 Lot No. 2
Site Plan Name: N/A Block No. 50
Project Name_ 5102 Palm Dr
DETAILED DESCRIPTION OF WORK:
We will tear off the existing shingle root down to the wood deck, nail off the deck
to the current code Install a self-adhesive HT underlayment with a 26 ga 5 V metal roofing system.
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: 2200 sq
Cost of Construction. $ $14,540.00
_ Generator
Windows/Doors Pond
Roof 4/12 Pitch
Sq. Ft. of First Floor: NJA
Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Donna Ni Conway
Name: Christopher Collins
Address: 5102 PALM DR
Company: Collins Roofing Inc
City: Fort Pierce FL State: _ _
Zip Code: 34982 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Address: PO Box 12867
City: Fort Pierce State. FL
Zip Code: 34979 Fax: N/A
Phone No 772-940-8607
E-Mail collinsroofinginc@gmail com
State or County License CCC-058011
it vawe or construction is z5uu or more, a KtLUKULL) Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL. CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
BONDING COMPANY: x Not Applicable
Name:
Address:
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
WAR "if
ure to Record a Notice of [ommencem ay ult In paying twice for
prove nterty. A Notice of Commenceme ust be rec e p c records of 5t.
Lucie unty�the jobsite before tFle first i ection. If n to obtain fin cing, consult
with nd efore "mmeneine work rec_ordine ur a of Commence ent.
i ure ner essee/ ontractor as Agent for Owner
Si atu tra ense Holder
STATE OF FLORIDA ���,,
STATE OF FLORIDA
COUNTY OF
COUNTY OF
Swygrfi to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
_,- ysical PrNnce Online Notarization
ysical Pres nce r Online Notarization
this day of 2020 by
thi ay of 2020 by
Yes Lb s
Name of pe s n making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Prod
Produced
(Signature of N P ReCilh
(Signature of Nota Pubiltr.y Late of 9
�; ary Pobl c - Shale of Florida
RDEN
Notary Pik _ Shale of Fhootla
Commission No. �nsslonA4Se� 2S
Commission No. earnmis5w 1i9025
m Eepres De, 1 2021
t * Comm E pres Dec 18.2021
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