HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR 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) 462-1578 Commercial Residential
y'-
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 5718 Oleander C-4-p Fort Pierce, FL 34982.
Legal Description: Avc.
ULRICH'S S/D BLK B LOTS 1, 2 AND 3-LESS W 1 1 FT FOR RD- AND ALL LOT4 (0.64 AC) (OR
2447-9n6)
Property Tax ID #: 3410-603-0016-000-4 Lot No. 4
Site Plan Name: Remove existing shingle roof covering down to the wood deck and install new Block No.
Project Name: SHINGLE ROOF REPLACEMENT
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: I
REMOVE EXISTING SHINGLES DOWN TO THE WOOD DECK AND INSTALL NEW
CONSTRUCTION INFORMATION:
AdItlona wor to e ner orme under this permit - c ec all apply:
C�HVAC L_I Gas Tank Gas Piping _ Shutters a Windows/Doors
Electric ❑ Plumbing Sprinklers Generator W1 Roof 4:12 Roof pitch
Total Sq. Ft of Construction: 3 !p (011. S . Ft. of First Floor: 3_ 10L-a
Cost of Construction: $ 29.500.00 Utilities: Sewer []Septic Building Height: 20'
OWNER/LESSEE:
Name Jerry Chauncey
CONTRACTOR
Name: Javier Solis
Address: 5.718 Oleander Ave.
Company: SOUS ROOFING CONTRACTORS INC.
Address: 2812 SW Shoal Ct
FORT PIERCE State: FL
Zip Code: 34982 Fax:
Phone No.
City: Port St. Lucie State: FL
Zip Code: 34953 Fax: 772-237-2006
Phone No. 561-662-6622
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mall: SOLISROOFINGINC@GMAIL.COM
State or County License: CCC1330147
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: x_ Not Applicable
Name:
Address:_
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ 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 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencine work or recordin`R vour.Notice of Commencement.
Signature ofPwner
r as Agent for Owner
STATE OF FLORI
COUNTY OF If)� / UU
The for g instrument was acknowledged before me
this _ day of , 20J_\ by
3e«y r H
Name of person rDa<ing statement
Personally Known V OR Produced Identification
Type of Identification
Produced
CS6
+Signure of Contractor/License Holder
OF FLORIDA N �� 0
TY OF
The for g instru en was acknowledged before me
this day of , 20a.( by
i
Sol'
Name of perso
aking statement
Personally Known
OR Produced Identification
Type of Identification
Produced
�� n
(Signature of Notary P - (Signature of Notary Public- St t ofMAMMIJAW �r.&00110"
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Commission No. MY � ES ApnT1,2o23 Commission No.1RES >� 23
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17