HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED OR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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) 462-1573 Commercial Residential X
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 3200 Ironwood Avenue
Property Tax ID #: _3425-702-0191-000-4 Lot No. 1
Site Plan Name: Block No. 19
Project Name: Broseman/ Re -hoof
I DETAILED DESCRIPTION OF WORK:
Re -Roof Shingle / 51rylignt
Underlayment - Weatherlock
Vent -
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator X Roof 2 Pitch
Total Sq. Ft of Construction: 1869
Cost of Construction: $ $9,735.00
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height: 15
OWNER/LESSEE:
CONTRACTOR:
Name Ken Broseman
Name: Robert Donovan
Addresss3200 Ironwood-Avenue
Company: Total Home Roofing
City: Port St. Lucie State: FL
Zip Code: 34952 Fax:
Phone No.772-807-1400
Address: 597 Haverty Court, Suite 40
City: Rockledge State: F
Zip Code: 32955 Fax:
Phone No 321-452-9223
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Christa@throofing.com
State or County License CCC1330489
If value of construction is $2500 or more, a RECC RDED Notice of Commencement is required.
If value of HVAC 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 TITLEHOLDER: _ 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.
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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Ow r essee/Contractor as Agent for Owner
Signature of Co r or/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Palm RParh
COUNTY OF Palm Raarh
The forty n nstrume was acknowledged .before me
da 20 by
The foir �instr t was acknowledge�tye�ore me
this da of 20 b
this of
494
Robert Donovan
RobertDonovan
Name of person making statement..
Name of person making statement.
Personally Known X OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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?° Jenica Hill<
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(Signature of Notary Pubcl - 't f
g ure of No lic-State of Florida )
�q ^Mate of Flonda
Commission No. (Seal)
Commission No. ` �al)
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