HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 9-10-21 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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r e ' Building Permit Application
Planning and Development Services x
Building and code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1SS3 Fax: (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 2704 Avenue R
Property Tax I #: 2404-608-0077-000-2 Lot No.
Site Plan Name: Block No.
Project Name: Rodrick Johnson
DETAILED DESCRIPTION OF WORK:
Re-Roof Shingle and Flat
New Electrical Meter Second Electrical Meter (Affidavit required)
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 x Roof Pitch
Total Sq. Ft of Construction: 5,226 Sq. Ft.of First Floor:
Cost of Construction: $ 20,000 Utilities: —Sewer —Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Rodrick Johnson Name: Donald Haight
Roofing&Reconstruction Contractors of America L
Address: 2704 Avenue R Company:
City:Fort Pierce State: FL Address: 1951 J &C Blvd
Zip Code: 34947 Fax: City: Naples State: FL
Phone No. 239 307-1641 E- Zip Code: 34109 Fax: (239)449-6301
Mail: brooke.tiberio@rrcaflorida.com Phone No (239) 307-1641
Fill in fee simple Title Holder on next page(if different E-Mail brooke.tiberio@rrcaflorida.com
from the Owner listed above) State or County License CCC1330395
If value of construction is 2540 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: 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 confIlcts with an applicable Homeowners Associatn rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consu� io
t with your Homeowners 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 ccncurrency 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 jobs ite before the first inspection, if you intend to obtain financing,consult
with lender or o rney before commencin g work or recordin g your Notice of Commencement.
Signature of Own esseeJContractor as Agent for Owner
STATE OF FLORIDA ST Lucie
COUNTY OF
Sworn to(or affirmed)and subscribed before me of X Physical Presence or Online Notarization
this 10 day of Sept ,20 21 by
Name of person making statement.
Noloy Personally Known X OR roduced Identification �'"} `" Brooke
su'�"r1ond'
&fluke Tibcrio
Type.nf ^ #ification Pro _ yew p+e a�izinG7HH
5
`(signature of Notary P ic-State of Florida)
Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
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COMPLETED
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