HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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 TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 2904 Sherwood Ln
Property Tax ID#: 2421-701-0014-000-2 Lot No. 14
Site Plan Name: Block No.
Project Name:Broseman/ Re-Roof
DETAILED DESCRIPTION OF WORK:
Re-Roof Shingle- Flat
Underlayment - Weatherlock
Vents - OC Ridge Ventsure
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 3 Pitch
Total Sq. Ft of Construction: 2897 Sq. Ft.of First Floor:
Cost of Construction:$ $13,060.00 Utilities: -Sewer _Septic Building Height: 15
OWNER/LESSEE: CONTRACTOR:
Name Dania Francois Brown Name: Robert Donovan
Address2904 SherwoodJ.n_. _ _. Company: Total Home Roofing
City: Fort Pierce State: FL Address: 597 Haverty Court, Suite 40
Zip Code: 34982 Fax: City: Rockledge State: F
Phone No.772-828-7685 Zip Code: 32955 Fax:
E-Mail: Phone No 321-452-9223
Fill in fee simple Title Holder on next page(if different E-Mail Christa@throofing.com
from the Owner listed above) State or County License CCC1330489
If value of construction Is$2500 or more,a RECORDED 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 MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: _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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or anscovenants 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 essee/Contractor as Agent for Owner Signature of Co r or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Palm Reach COUNTY OF Palm Reach
The for ing mstr as acknowledge before me The fo Ing Instrument as acknowledB�d pefore me
this day of 20 by thisT day of (Y .2Q�( by
Robert Do Vail Robert Donovan
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
Si ature of Notary ublic-State of Florida) u Notary Public-State of Florida
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