HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
L Li
W NT' I �
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
Residential x
PERMIT APPLICATION FOR: reroof
PROPOSgp 1, li'ROVEMENT LOCATION:
Address: 791 Sandburg Ln
Property Tax ID #: 3415-705-0103-000-9 Lot No.
Site Plan Name: Block No.
Project Name: Paul - 791 Sandburg Ln
DETAILED DESCRIPTION OF WORK;
Remove existing iooi to ceck: renaii to cote. Instali :,A underlayment & architectural shingles.
OWNER/LESSEE:
Name Helen Paul
Address: 791 Sandburg Ln
City: PSL State:r-
Zip Code: 34952 Fax: -
Phone No. 772-489-4863
E-Mail: -
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: L10"9as
Company: Code Red Roofers, Inc
Address: 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
— �U[F�LIu«IuII n cauu or more, a KtLunutu Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
' '+ NSTRUCTION LIEN LAW INFORMATION. —1
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: X Not Applicable
BONDING COMPANY: X Not Applicable
Name:
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 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 commencin work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF rnQx4fn COUNTY OF MOi-- tl
Swgrn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
✓ ✓Physical
Physical Presence or Online Notarization Presence or Online Notarization
this day of ��'LL 2021 by this day
_30 of �j U1� 2020 by
'DOUG Icts tr 2a-- 'I-7p_4l ,r,5 %-
Name of per n making statement. Name of Per6ln making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(' natur of Notary Public- of FloridadAYNAJ. REGIS gnat of Notary Public- a of�)orida) DAYNAJ. REGIS
2
m ion # HH 053320 * * Commission # HH 053320
Commission No. * - ea[ Commission No. �P
x'ire October 14, 2024 (rxpf?� October 14, 2024
c� 0�
y'tFOF F..0P Boller Thru Budget Notary Services ��F OF FI�P Bonded TtlU "et Notary Sermas
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20