HomeMy WebLinkAboutBuilding Permit App NotarizedAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 06/18/2021
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
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: 5950 Whipoorwill Ln, Fort Pierce, FL 34987
Property Tax ID #t: 3211-811-0020-000-3
Site Plan Name: HIDDEN ACRES BLK C LOT 5 (2.89 AC)
Residential xx
Project Name: Oswald, Sumer - Roof
DETAILED DESCRIPTION OF WORK:
Remove existing shingle roof down to decking. Install self -adhered membrane, mechanically fastened.
Install 1" Snap -Lock, standing seam, 24 gauge metal roof system.
New Electrical Meter N/A Second Electrical Meter N/A
CONSTRUCTION INFORMATION:
Lot No. 5
Block No. C
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 3 8,4 Pitch
Total Sq. Ft of Construction: 3,442
Cost of Construction: $ 20,720.00
Sq. Ft. of First Floor: N/A
Utilities: —Sewer —Septic Building Height: AVG - 19
OWNER/LESSEE:
CONTRACTOR:
Name Sumer Oswald
Name: Jason Morar
Address: 5950 Whipoorwill Ln
Company: Southern Roof Systems, Inc
City: Fort Pierce State: rL
Zip Code: 34987 Fax:
Phone No. 305-613-2085
Address:2685 SW Domina Rd
City: Port Saint 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-Mail Jason@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: T Not Applicable
Name: _
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: —T 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 noxxwork or installation has commenced prior to the issuance of a permit.
which is inOcontlictawith any applicablelHo eat is Ownners Associationnting a irules,ill by bylaws or and covenants that build
prstructure
h bits ch
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 attp rdin our Notice of Commencement.
__yney before commencirl worJSignat
Signa re of Owner/ ssee(//Contractor as gent for Owner
of Contractor/Licens4Ho er
STATE OF FLORIDA
COUNTY OF , [ ;r
STATE OF FLORIDA
COUNTY OF�t41C , p
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this 21 day of ;'SS-10 -e— 2026 by
Sworn to (or affirmed) and subscribed before me of
_—physical Presence or Online Notarization
this,�R� day of 2020 by
V
Name of person making statement.
Name of person making statement.
Personally Known -- OR Produced Identification
Type of Identification
d
Personally Known — — OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State F
00
(Signature of Notary Publi S a e of Florida)
Commission No. _. °�r� N°�pi1c State a Flprpa
. Da ontanero
My Commission GG 191669
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J+r •4 NotaryPublic State of
olrmission No. a arlyne Montanero
u r_ M Commission GG 1
Expires 03/01/2022
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REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVI OR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED _
DATE
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COMPLETED
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