HomeMy WebLinkAboutBuilding Application - 928 Campbell RdAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
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Permit Number:
OMN'i• • ' 1 •
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Re -roof
Address: 928 Campbell Road, Fort Pierce, FL 34945
Property Tax lD #i: 2309-433-0000-000-4
Site Plan Name:
Project Name: Saleh
Residential x
Lot No. —
Block No.
Tear off existing shingle roof, replace plywood as needed, re -nail deck to code as needed, install self -adhered underlayment
install shingles to code
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit —check all that apply:
Mechanical Gas Tank
_ Electric — Plumbing
Total Sq. Ft of Construction: 11,450
Cost of Construction: $ 13,500
— Gas Piping
__ Sprinklers
_ Shutters _ Windows/Doors Pond
_ Generator _�K_ Roof
Sq. Ft. of First Floor: 11,450
Pitch
Utilities: — Sewer __ Septic Building Height: 15'
Name Ibtesam Saleh
Address: 928 Campbell Road
City: Fort Pierce State: _
Zip Code: 34945 Fax:
Phone No. 772-333-6960
E-Mail: yasminesaleh15@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: John S. Morales
Company: Stanislaus Enterprise Inc.
Address: 5830 Whippoorwill Lane
City: Port Saint Lucie State: FL
Zip Code: 34986 Fax:
Phone No 772-342-4744
E-Mail seicon1 @gmail.com
State or County License CCC1327753_
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.
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DESIGNER/ ENGINEER: Not Applicable
p licable
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 attorne before commencing work or recording our Notice of Commencement.
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Signature of Owner essee/Contractor as Agent for Owner
Signature of C actor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Saint Lucie
COUNTY OF Saint Lucie
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
X Physical Presence or Online Notarization
this 18th day of May 2020 by
this 18th day of May 2020 by
John S. Morales
John S. Morales
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
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Produced
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(Signature of No ry u ZicASt6te of Florida)
(Signatur f o u lic State of Florida )
Commission No. (Seal)
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