HomeMy WebLinkAboutBUILDING PERMIT APPLICATION - 5930 TRAVELERS WAYAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. 7-23-2021 Permit Number:
`i ILL!LLL
r
L, L C �' ii Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: REROOE
PROPOSED IMPROVEMENT LOCATION:
Address: 5930 TRAVELERS WAY FT PIERCE
Property Tax I❑ #: 3410-503-0113-000-7
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Residential X
Lot No.17
Block No. D
REMOVE SHINGLE ROOF
INSTALL PEEL & STICK UNDERLAYMENT FL2569
INSTALL SHINGLE FL10674 INSTALL RIDGEVENT NOA NO. 19-1217.03
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit — check ail that apply:
_Mechanical _ Gas Tank —Gas Piping , Shutters _ Windows/Doors Pond
_ Electric , Plumbing _Sprinklers —Generator x Roof 5/12 Pitch
Total Sq. Ft of Construction: 1,972 Sq. Ft. of First Floor: 1,972
Cost of Construction: $ 10500 Utilities: — Sewer _ Septic Building Height: 8 FT
OWNER/LESSEE:
Name anya agner
Address: 13528 58th Ct
City: Ronal Raim Beach State: FL
Zip Code: 341 1 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: ROLAND WILEY
Company: SHORELINE ROOFING
Address: 1973 SW GLENDALE STREET
City. PORT ST LUCIE State: FL
Zip Code: 34987 Fax.
Phone No 772-260-95135
E-Mail SHORELINEROOFING YAHOO.COM
State or County License CCC1331170
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
State: City: State:
City: Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: 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.
5t. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subiect 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 ail respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The fo#lawing building permit appf!cations 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 Country and posted on the }obsite before the first inspection. if you intend to obtain financing, consult
j;wfMlender or attorne before commencn work or recordin our Notice of Commencement.
li
Signature of Owners Lessee/Contractor as Agen for Owner
`J
STATE OF FLORIDAr .. l
COUNTY OF
SW t9 jor affirrn d and ubscribed b me of Physical Presence or Online Notarization
tray of by
tjq, t .1
Name of person making
Personally Known
Type ,of Identification
OR Produced identification
(Signature of Not P blic- State of Flo jda
BRANDY MOORE
Commission No.-- Ld
j.-� ,Notary Puhlie-Staes of PVorlda
�i Commission # HH 108395
my Commission Expires
Mav 09. 2025
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