HomeMy WebLinkAboutST Lucie Permit Application 2021 (2)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
La
. .i�
P, L` a Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address:
2001 N 44th ST FORT PIERCE FL 34947
Property Tax ID #
Site Plan Name:
2406-501-0004-000-8
Project Name: WILLIAMS RESIDENCE
DETAILED DESCRIPTION OF WORK:
Lot No. 4 &5
Block No.
REMOVE EXTIS-TING, ROOF SYSTEMS ON THE El AT AND THE -3119 PITCHED ROOFS
REPLACE PITCHED ROOF SYSTEM WITH 5V 24GA METAL AND THE FLAT WITH
New Electrical Meter Second Electrical Meter.
CONSTRUCTION INFORMATION:
(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
Total Sq. Ft of Construction: 1800
Cost of Construction: $ 10,231.44
_ Sprinklers
Generator _\/_ Roof 3/12 Pitch
Sq. Ft. of First Floor: 1800
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name_ Lerius William
Name: DOUG_
Address: PO BOX 2103
Company:ORCHID ISLAND ROOFING_
Address: 18-56 US HIGHWAY I
City: Fort Pierce, FL 34954State: ___.
Zip Code: Fax:
City: VERC L RREA-CH State: FL
Phone No.
Zip Code: 32�m Fax: 7729992101
E-Mail:
Phone No 7726435950
E-Mail dou oiroofs.Com
Fill in fee simple Title Holder on next page ( if different
State or County License
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:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE BOLDER: 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.
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 attorney before commencing work or recording our Notice of Commencement.
f
Signatures -of 0 ner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
Physical Presence Online Notarization
5warx o {or affir d) and su scribed 6ef a me of or
this day of 26�1 by
Name of person making statement.
Personally Known ✓ OR Produced Identification
Type of dentificativn Pr uced
(Signature of Notary Public- State )
��o--f��Flll�orida
Commission No. SV (Seal) ,��jvv'��.,� CARALEEWELLS
$e,`'r'a. Notary Public • State of Florida
Commission # HH 07bb50
ar°My Comm. Expires Jan 3, 2025
Bonded through National Notary Assn,
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