HomeMy WebLinkAboutKelly-roof permit application.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/19/2021 Permit Number:
J a
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITAPPLICATION FOR:Alliance Group
PROPOSED IMPROVEMENT LOCATION:
Address: 10830 Kimberfyld Lane Port St. Lucie, FL 34986
Property Tax ID #: 3321-501-0021-000-6 Lot No.
Site Plan Name: Block No.
Project Name: Chris Kelly
DETAILED DESCRIPTION OF WORK:
Remove existing cedar shake roof, reinforce trusses per engineer drawing (Included with this permit application)
install 30# felt and Polyglass TU Plus tile undedayment, install 24-gauge metal flashings and install 13" flat concrete
roof tiles with foam roof tile adhesive
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 XRoof 6/12 Pitch
Total Sq. Ft of Construction: 4,596 Sq. Ft. of First Floor:
Cost of Construction: $ 86,576.00 Utilities: -Sewer —Septic Building Height: 10'
OWN NTRACTOR:
Name Chris Kelly Name: Danielle Ryckman
Address: 10830 Kimberfyld Lane Company: Alliance Group
City. Port St. Lucie State: Fi Address: 615 NW Enterprise Drive
Zip Code: 34986 Fax: City: Port Saint Lucie State: FL
Phone No. (914) 282-1349 Zip Code: 34986 Fax:
E-Mail: chris.kelly@yahoo.com Phone No 772-492-8006
Fill in fee simple Title Holder on next page ( if different E-Mail adamleeryckman@gmail.com
from the Owner listed above) State or County License CCC 1330918
If value of construction is 25M 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: I `
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ 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 attorney before commencing workQr recardjoa your Notice of Commencement.
Signature of as Agent for Owner
Signatu�ntractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this is day of wy N2W by
�
x Physical Presence or Online Notarization
this +s day of May iQ26^ `y
iD
Danielle Ryckrnan
Danielle Ryckman
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
Produced
Type of Identification
Produced
(Signat Notary Public- State 'da) Ryan R. Salblc
(Signature of Nof5iry Public- Sta oricIftion R. Soft
Notary Public
Commission No. ( ittate of Florida
Notary Public
Commission No. '§tRAbf Florida
Comm#HH123937
a Comm#HH123937
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