HomeMy WebLinkAboutPhillips Application - NotarizedAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05/26/2021
Permit Number:
..1urL11C
J J.. :.
L' Building Permit Application
Planning and Development Services
Building and Code Regulation Division COn'll"1'lercial Residential xx
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Residential Re -Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 8250 Sand Pine Circle
Property Tax ID #: 3426-703-0030-000-4
Site Plan Name: LAKE LUCIE ESTATES PLAT NO. ONE LOT 16
Project Name: Phillips, Jenny - Roof
Lot No. 16
Block No. N/A
DETAILED DESCRIPTION OF WORK:
Remove existing shingle roof down to decking. Install self -adhered membrane, mechanically fastened. Install two skylights.
Install 1" Snap -Lock, standing seam, 24 gauge metal roof system.
New Electrical Meter N/A Second Electrical Meter N/A
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 � Roof 6 Pitch
Total Sq. Ft of Construction: 3,650
Cost of Construction: $ 23,983.00
Sq. Ft. of First Floor: N/A
Utilities: _ Sewer _ Septic Building Height: avg —13
OWNER/LESSEE:
CONTRACTOR:
Name Jenny and Scott Phillips
Name: Jason Morar
Address: 8250 Sand Pine Cir
Company: Southern Roof Systems, Inc
City: Port St Lucie State:—
Zip Code: 34952 Fax:
Phone No. 516-480-3790
Address: 2685 SW Domina Rd
City: Port St Lucie State: FL
Zip Code: 34953 Fax:
Phone No 772-324-9613
E-Mail: N/A
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailjason@southernroofsystems.com
State or County License CCC1332470
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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 attornev before commencing work or record rig your Notice of Commencement.
Signa lre of Owner/ ssee/ ntractor Agent for Owner
Signature of ontractor/Li se Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S't . L
COUNTY OF S-Y • Lk-., L -.-
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
ysical Presence or Online Notarization
Physical Presence or Online Notarization
thi day of CA, 2020 by
this day of YYi g S, 2020 by
t' �o c� YYZ � rr C, /-
CA_ m U c r
Name of person making statement.
Name of person making statement.
Personally Known —FOR Produced Identification
Personally Known -_----OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Signature of Notary Public
ignature of Notary
•�r Notary Public State of Florida
Commission No. `F
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G� r • Notary Public State of Florida
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LDS Montanero
mmission No. l" _Darlyne 4beWjero
My Commission GG 191669
4"� • `, Expires 03/01/2022
, ,. _ My Commission GG 191669
I' Expires 03/01/2022
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Rev. 5/6/20