HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date Permit Number:
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: Re Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 5509 Raintree Trail
Property Tax ID #: 3402-610-0012-000-3 Lot NO2
Site Plan Name: NIA Block No, 59
Project Name: Tear off and Re -roof
DETAILED DESCRIPTION OF WORK:
We will tear off the existing roofing systerm, nail the deck off to current code, install a secondary water resistant barrier
and a 5-V metal roofing system.
New Electrical Meter NIA Second Electrical MeterN/A
CONSTRUCTION INFORMATION:
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 Pitch
Total Sq. Ft of Construction: 3294 Sq. Ft. of First Floor: N/A
Cost of Construction: $ 21,000.00 Utilities: Sewer _ Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Brent Lane
Name: Christopher Collins
Company:Collins Roofing Inc.
Address:5509 Raintree Trl
City: Fort Pierce, FL State:
Address: PO Box 12867
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-971-6629
Zip Code: 34979 Fax: NIA
E-Mail:jesslane68@yahoo.com
Phone No 772-940-8607
E-Mail collinsroofinginc@gmail.com
Fill in fee simple Title Holder on next page ( if different
State or County License CCC-058011
from the Owner listed above)
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:
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DESIGNERANGINEER: Not
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: 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 exem t from undergoing a full concurrency review: room additions,
accessory str es, swr ng pool ces, walls, sign , creen rooms and accesso another non-residential use
WAR G TO OWNER: Y r failure to Record a Noti a of Commen ent may result ng twice for
provements to ur property. A Notice of Co mence nt must be recor in the public record of St.
Lucie County a p don the jobsite bef e first i spection. If you i nd o obbt In financing, c insult
with lender o tt rnev before co cin wor r recordinR vour tice fC�mme Z est.
i
rgna f Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDAt
STATE OF FLORID
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Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of — 22 eby
) Physical Presence or Online Notarization
this LL day of y
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Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known is OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced_ P�:L IA
(Signature of Notary Public - State of Florida)
(Signature of Notary Public- State of Florida
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Commission No. (Seal)
Commission No. (Seal)
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