HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 04/09/2021 Permit Number:
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:Reroof
PROPOSED IMPROVEMENT LOCATION:
Address: 9418 Poinciana Court
Property Tax ID#: 1334-503-0014-000-4 Lot No. 12
Site Plan Name: Schultz Block No.
Project Name: Schultz
DETAILED DESCRIPTION OF WORK:
Remove existing roof system down to decking, renail to code, install hi temp underlayment
install 1"standing seam metal roof system
New Electrical Meter Second Electrical Meter
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 A
Roof 6/12 Pitch
Total Sq. Ft of Construction: �� 0 Sq. Ft. of First Floor: 3700
Cost of Construction:$ 26,265.00 Utilities: —Sewer _Septic Building Height: 20
OWNER/LESSEE: CONTRACTOR:
Name Jack Schultz Name:Richard Colletti
Address:25 Chatham Road Company:Leakbusters Roof Repair
City: Ardmore PA State:_ Address:6101 Buchanan Drive
Zip Code: 19003 Fax: City: Fort Pierce State:FL
Phone No. Zip Code: 34982 Fax:
E-Mail: Phone No 7723328450
Fill in fee simple Title Holder on next page(if different E-Mail richiecolletti@gmail.com
from the Owner listed above) State or County License 29763 CCC1330976
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: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: oe 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 attorpey before commencing work or recording our Notice of Commencement.
Signature of Owner/Le see/ ontractor as Agent for Owner Signature of Contractor/License Prorder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF I COUNTY OFF
SyviWn to(or affirmed)and subscribed before me of Swgrn to(or affirmed)and subscribed before me of
Pil ical Presence or Online Notarization h sical Prese a or Online Notarization
thi day of 2026 by tfiis day of 202f� by
me of person making st tement. Name o person making sta ment.
Personally Known _OR Produced Identification Personally Known 1 OR Produced Identification
Type of Identification Type of Identifica ' n
PrnAuced Produced
VA
,(Signature of Notary Public-State of F ' o Notary
parr KATHERINEHAVENi ' THERM HA`�;NS
Commission No. : . MISSION#GG1650o. $ *�F ,tSIDN#RM E 50?,,
Commission No.
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED