HomeMy WebLinkAboutPermit App-3808 Avenue RAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/25/21 Permit Number:
T. L U I E
V• Cl T'Y
F L O R I D 9--
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
PERMIT APPLICATION FOR:COLLIS ROOFING INC.
PROPOSED IMPROVEMENT LOCATION:
Property Tax ID #: 2405-601-0142-000.1
Site Plan Name:
Project Name: Brown Residence
DETAILED DESCRIPTION OF WORK:
Asphalt shingle and Mod Bit roof replacement
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
_ Electric _ Plumbing
Total Sq. Ft of Construction: 2034
Cost of Construction: $ 20,095
_Sprinklers Generator
Sq. Ft. of First Floor:
Residential X
Lot N0.21 & 22
Block No. 7
Windows/Doors Pond
_ Roof 4/12 Pitch
Utilities: _ Sewer _ Septic Building Height: 15ft
ER/LESSEE:
CONTRACTOR:
at A Brown
J. Douglas glas Lanier
rAddress:3808 Avenue RCompany:
Collis Roofing Inc.
rt Pierce State: _
34947 Fax:
Phone No.
E-Mail:
Address:3970 Dow Rde:
City: Melbourne State:Fl
Zip Code: 32934 Fax: 3217512307
Phone N03217518850
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If value of construction Ic 7Snn
E-Maildsmith@collisroofing.com
State or County LicenseCCC058022
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: x Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
�u iwlrn, n
_
---•--••r MFIFluvi 1. Application is nereoy made to obtain a permit to do the work and installation as indicated.
I certify that noworkor installation has commenced prior to the issuance of a permit.
ucie
unt
no
wthich is inoconfli t witmakeh any applicable Ho eat is Owners Assonting ciation rules authorize
or and covenants holder
ot may restricthe borr prof 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 attnrnpv hpfnrp rnmmcnrina .... ,[, ,...,.,.. A;
--. -............. ..
,,, n �u wvuce ui wrnrnencemeni.
Q L /gym
Si ature of Co ractor/License Holder
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORID
COUNTY OF
/
COON Y OF �}
Sworn to (or affirmed) and subscribed before me of
Sw n to (or affirmed) and subscribed before me of
_Physical Presence or Online Notarization
Physical Presence or Online Notarization
this _ day of , 2020 by
this day of , 202f by
Name of person making statement.
Name of person ma
Personally Known OR Produced Identification
-kintatement.
Personally Known `'/ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
gnature of Notary Public- o
Commission No. (Seal)
Seal
Notary Public Stale
�aaG.Radill
Commission No. n IGlO
I)rty Commiealon HH1
or E"prea 05106M5
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
—
COMPLETED
ev.