HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
0
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
PERMIT APPLICATION FOR: Re -Roof Flat
PROPOSED IMPROVEMENT LOCATION:
Address: 5208 Paleo Pines Cir Fort Pierce, FL 34951
P rope rty Tax ID #: 1312-801-0090-000-7
Site Plan Name: Chris Block
Project Name: Chris Block
DETAILED DESCRIPTION OF WORK:
Remove existing flat roof and replace with new SAP SAV Modified Flat System
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential X
Lot No.
Block No.
Additional work to be performed under this permit —check all that apply:
_Mechanical ` Gas Tank —Gas Piping ` Shutters Windows/Doors Pond
_ Electric _ Plumbing `Sprinklers
Total Sq. Ft of Construction: 700
Cost of Construction: $ 8,300.00
OWNERAESSEE:
Name Chris Block
Generator _ Roof 0/12 Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height: 12ft
Address: 208 Paleo Pines Cir
City: Fort Pierce State: _
Zip Code: 34952 Fax:
Phone No. (772)528-0113
E-Mail: PDKRoofing.lnc@gmail.com
Fill in fee simple Title Holder on next page i if different
from the Owner listed above)
CONTRACTOR:
Name: Dee Keihn
Company: PDKRoofing.inc
Address: 1761 SW Biltmore Street
City: Port Saint Lucie State: FL
Zip Code: 34984 Fax:
Phone No (772)528-0113
E-Mail PDKRoofing.lnc@gmail.com
State or County License CCC1331408
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:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
City:
Address:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to 0o ir,e wvr r anu IIISLa
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
sthucturepPleasle eonisult w,thpyour HomeOwners0 �ers Assoe+atcon and review your deed for any restrict that
which ma oa prohibit such
Y 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.
Lug� County and posted on the lobsite before the first i ction. If you intend to obtain financing, consult
wdth tender or an attorney before commencing work or ec rdin our t - g of C mmencement.
Signature of Owner/ Le/see/Contractor as Agent for Owner
Holder
STATE OF FLORIDA . �. STATE OF FLORIDA
COUNTY OF Jl LLCE C COUNTY OF �-
Sw\qrn to (or affirmed) and subscribed before me of
`R. Physical Presence or Online Notarization
this—'>k day of _ &W , 2020 by
n --,C-, �� r
Name of person making statement.
Personally Known >— OR Produced Identification
Type of Identification
Produced _-
Sworn to (or affirmed) and subscribed before me of
_jL Physical Presence or Online Notarization
thisc�L I day of 2020 by
Name of person making statement
Personally Known V OR Produced Identification
Type of Identification
Produced
(Sikirkture of Notary Publi I 'gnatke of Notary Publi
NDERAGUIRRE s+"Y" ALEXANRERAGUIRRE
Commission No. N[t"o MISSION# GG 23481 C mmission No. :*= MY69ASS ION # GG 234811
�= EXPIRES: July 4, 2022 ; _ `,= EXPIRES: July 4, 2022
y C•
BondedThtuNOte Pubi ''Fd�F`°'
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
COMPLETED