HomeMy WebLinkAboutpermit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
O
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
Address: 3403 Avenue T, Fort Pierce 34947
Property Tax ID #: 2405-601-0071-000-2 Lot No.
Site Plan Name: Block No.
Project Name: Henson-3403 Ave T
Remove existing slope roof material to deck; renail to code. Install SA underlayment, & 5v metal roof.
New Electrical Meter
Second Electrical Meter
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters -Windows/Doors
Electric Plumbing _ Sprinklers _ Generator Roof 3_5
Total Sq. Ft of Construction: 2400 Sq. Ft. of First Floor:
Cost of Construction: $ 15700 Utilities: —Sewer _ Septic
O NERf LESSEE:
Name Mary L 'Henson
Addracc. 3403 Avenue T
City: Fort Pierce State:
Zip Code: 34947 Fax: n/a
Phone No. 772-979-6279
E-Mail: MLHenson19@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Kl;,m, Douglas E. Roe
Pond
Pitch
Building Height: 10,
Company: Code Red Roofers, Inc
oddrP«• 3341 SE Slater St
City: Stuart State: FL
Zip Code: 34997 Fax: _
Phone No 772-287-2829
E-Mail Permits@coderedroofers.com
State or County License CCC1326574
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:
Name:
Address:
Citv:
Zip: Phone
x Not Applicable
State
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
Address:
City:
Zip: Phone:_
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:
BONDING COMPANY
Name:
Address:
Citv-
Zip : Phone:
X Not Applicable
State:
X Not Applicable
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
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Signature of Contractor/License Holder
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
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STATE OF FLORIDA
COUNTY OF ✓Y1 G� �'L
COUNTY OF(Ll��l
Sworn to (or affirmed) and subscribed before me of
Swor o (or affirmed) and subscribed before me of
Online Notarization
V Physical Presence or Online Notarization
Physical Presence or
2020 by
this I-1 day of 202( by
this 1_( day of ,
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Name of person aking tatement.
Name of person Waking statement.
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Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(S' ature Notary Public ate of Florida)
(Si nature Notary Public- State Florida )
PUBIA DAYNAJ.REGIS
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Commission No. _ ' 06b4ission#HH053320
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Commission No. c*(S1 A)nission#HH053320
" * Expires October 14, 2024
N� O` Expires October 14, 2024
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