HomeMy WebLinkAboutPermit ApplicationAIIAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:Permit Number:
Building Permit Application
Plonning and Development Services
Building ond code Regulation Division Commercial _ Residential
2300 Virginia Avenue, Fort Pierce FL j4982
Phone: (7721 462-1553 Fax: {772l. 462-1578
PERM lT APPLICATION FOR: pgpggf
PROPOSED I M PROVEM ENT LOCATION:
Address: 120 E. Arbor Ave.
Property Tax lD g' 3419-515-0051-000-8 Lot rvo.24
Site Plan Name:Block No. 5
Project Name:
DETAILED DESCRIPTION OF WORK:
Remove shingles and renail plywood. Apply Resisto self adhering shingle underlayment. lnstall dimensional shingles.
Flat Roof: Apply two layers of Polystick SAV base sheet and one layre of SAP cap sheet.
New Electrical Meter Second Electrical Meter
CONSTRUCTI ON I NFORMATION :
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping
_ Sprinklers
_ Shutters _ Windows/Doors _ Pond
_ Generator _ Roof _ Pitch
Sq. Ft. of First Floor: _
_ Electric _ Plumbing
Total Sq. Ft of Constru.l;6n' 1900
Cost of Construction: $ 9,400'00 Utilities: _ Sewer _ Septic Building Height:
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
lf value of HAVC is 57,500 or more, a RECORDED Notice of Commencement is required.
OWNER/LESSEE:CONTRACTOR:
NameMary Ann Peiffer
Address:120 E. Arbor Ave.
City: Port St. Lucie State: _
ZiP Code: 34952 Fax:
phone 116. 41 2-500-6923
g-1y1u11. None
Fill in fee simple Title Holder on next page { if different
from the Owner listed above)
Name: David Packard
Company . Packard Roofing & Waterproofing, [nc.
466rs55.2182 NW Reserve Park Trace
City: Port St. Lucie State:FL
Zip Code: 34986 P2y' 772-468-9978
phone Ns772468-3723
g-1y, ; I ssmith @packard roofi ng.com
State or County 1iqs65s CCCA1 751 7
ELOLLLDA
SUPPLEM ENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name:
Address:
City:State:
zip:Phone
MORTGAGE COMPANY: x Not Applicable
Name:
Addr
City:
.ESS:
State:
zip:Phone
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
Add
City
zip:
ress:
Phone:
BONDING COMPANY: x Not Applicable
Name:
Address:
City:
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 Countv makes no representation that is erantins a permit will authorize the permit holder to build the subiect structure
which is in conflict with anv a'pplicable Home Owhers AsSociation rules, bvlaws or and covenants that mav restrict or prohibit suchstructure. Please consult with your Home Owners Association and review'your deed for any restrictions Which may apply.
ln 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 structurel swimming poolq fencel 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. lf you intend to obtain financing, consult
with lender or an atto before commencing work or recordi r Notice of Commencement.
'actor as Agent for Owner
STATE OF FLORIDA
couNTY oF -(+. Lnu ?
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Personally Known I OR Produced ldentification
Type of ldentification
Produced-
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(Signature of Notary
Commission No.
Name of person making statement.
STATE OF FLORIDA
COUNW OF Sh r*t uY
Sworn to (or affirmed) and subscribed before me of/Phvsical Presence or Online Notarization
tf",it -a1 daV of lvttut lott ,2020 by
Name of person making statement.
Personally Known "/ oR Produced ldentification
Type of ldentification
Produced
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.,,?S*2,.".. My Comm. Exoires 5eo 2, 2021
FRONT
COUNTER
SUPERVISOR
REVIEW
ZONING
REVIEW
DATE
COMPLETED