HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/5/21
Permit Number:
coca �,_
° a @) R� ° ° � 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: MODIFIED REROOF
PROPOSED IMPROVEMENT LOCATION:
Address: 4164 LEBANON RD FT PIERCE, FL 34982
Property Tax ID #: 2434-313-0006-000-2
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
REMOVED EXISTING MODIFIED ROOF AND INSTALL A NEW MODIFIED ROOF
FL# 1654 (W-209) POLYFLEX G, ELASTOFLEX SAV
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
Lot No.
Block No.
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator X Roof 1.5/12 Pitch
Total Sq. Ft of Construction: 1500
Cost of Construction. $ 9950
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height: 1 STORY
OWNER/LESSEE:
CONTRACTOR:
Name MARC PAULINO & JENNA THOMAS
Name: ANDREW GRIFFIS
Address: 4164 LEBANON RD
Company: ALL AREA ROOFING & CONSTRUCTION
City: FT PIERCE State: j
Zip Code: 34982 Fax:
Phone No. 772-940-2229
Address: 3921 S US HWY 1
City: FT PIERCE State: FL
Zip Code: 34982 Fax: 772-464-6600
Phone No 772-464-6800
E-Mail: APMARC95@GMAIL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail FAITH@ALLAREAROOFINGFTP.COM
State or County License CCC1330649
It 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: x Not Applicable
Name:_
Address:
City:
Zip:
Phone
State
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone: -
x Not Applicable
State:
BONDING COMPANY: x Not Applicable
Name:_
Address:
City:_
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.
Luci ounty and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
wioX lender or alb attorney before commencing work or recording dour Notice of Commencement.
ture of Owner
STATE OF FLORIDA
COUNTY OF STLUCIE
r as Agent for Owner 15lghature of Contractor/Li
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this 5 day of AUGUST , 2021 by
ANDREW GRIFFIS
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Pro ed _
ign lure of Notary Public- State of Florida )
=O`PlkY P&" FAITH MASON
Commission No. * C4rfr8ibn#GG960757
N9,- ��oQ Expires June 20, 2024
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COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
STATE OF FLORIDA
COUN 1TIvOF STLUCIE
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this 5 day of AUGUST 2021 by
ANDREW GRIFFIS
Name of person making statement.
Personally Known x OR Produced Identification
Type of entification
Produce
(Sign a of l7o7lary Public- State of Florida )
o�Pnv rues, FAITH MASON
Commission No. a ` CorrOMd # GG 960757
�
W„ , �= Expires June 20, 2024
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