HomeMy WebLinkAboutHAZY BUILDING PERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7119/21
Permit Number:
Jo U CM
a zD Building Permit Application
Planning and Development services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Reroof
Address: 6202 E Seminole Rd Fort Pierce, FL 34951
Property Tax ID q: 1301-606-0084-000-9 Lot No.1 &2
Site Plan Name: Tprpca Hazy Block No. 62
Project Name:
Remove and replace roof, shingle to shingle.
New Electrical Meter Second Electrical Meter (Affidavit required)
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 5/12 Pitch
Total Sq. Ft of Construction: 1,710 Sq. Ft. of First Floor:
Cost of Construction: $ 20000 Utilities: —Sewer —Septic Building Height:
GVI%1 E /LESSEE V : _
td'NT01G02dR'
Name Teresa Hazy
Name:Donaid Haight
Address: 69O9 F Spminnip Rrf
Company: Roofing & Reconstruction Contractors of America, LLC
city: Fort Pierce State: FI
Zip Code: 34951 Fax:
Phone No.
Address: 1951 J & C Blvd
City: Naples State: FL
Zip Code: 34109 Fax:
Phone No 239-449-6301
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail eye. engelhartrrcaflorida com
State or County License CCC1330395
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.
#t�JPPLENITA1� NS RUG 4j010ElVV�
�.._
DESIGNER/ENGINEER: _ Not Applicable
Name:
ORM�T Off"'-
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.
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 attornev before commencing work or recording vour Notice of rnmmPnrPnnPnt
as
STATE OF FLORIDA
COUNTY OF Collier
Sworn to (or affirmed) and subscribed before me of
this 19 dayof JULY 2021 by
Donald Ha'
ame of person making statement.
X Physical Presence or_ Online Notarization
Personally Known OR Produced Identification X
Typ of Id itification Pro TX DL
(S!Watuffi df Notary -State of Florida )
Commission No. 964348 (Seal) r�tokyPN¢,
*x
��OFF��QPe
EVER ENGELHART
0ommMon#GG964348
E*Ire$ MaMhZ 2U24
Bandnm&WgdNo ys AM
REVIEWS I FRONT I ZONING SUPERVISOR I PLANS I VEGETATION SEATURTLE I MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW I REVIEW