HomeMy WebLinkAboutPermit App-2302 N 45th StAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/25/21 Permit Number:
Or. [LUC E
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
PERMIT APPLICATION FOR:COLLIS ROOFING INC.
PROPOSED IMPROVEMENT LOCATION:
Address: 2302 n. 45th ST
Property Tax ID #: 1431-801-0093-000-4
Site Plan Name:
Project Name: Anderson residence
Lot No.7
Block No. 9
I DETAILED DESCRIPTION OF WORK: I
shingle and Mod Bit roof replacement
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: 1384
Cost of Construction: $ 14,522
_ Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof 1/12 & 3/12 Pitch
Utilities: —Sewer _Septic Building Height: 12fc
OWNER/LESSEE:
CONTRACTOR:
Name Daphnee S Anderson
Name:. Douglas Lanier
Address:2302 N 45th St
Company: Collis Roofing Inc.
City: Fort Pierce State: _
Zip Code: 34946 Fax:
Phone No.
Address:3970 Dow Rd
City: Melbourne State:Fl
Zip Code: 32934 Fax: 3217512307
Phone No3217518850
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Maildsmith@collisroofing.com
State or County License CCC058022
it value of construction is Z500 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: X Not Applicable
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 clothe 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 work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Sig ture of Co actor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORICI
COUNTY OF `7�. �� A
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
_ Physical Presence or _ Online Notarization
this day of , 2020 by
�� Ply ical Presence or Online Notarization
this ay of 12024 by
Name of person making statement.
Name of person making s ement.
Personally Known OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification
Type of Identification
Produced
Produ
F
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2
(Signature of Notary Public- State of Florida)
Commission No. (Seal)
(Signature of Notary Public- Aate o
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Commission No.U_LX91q ill r
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