HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l Permit Number:
S-L.. Li i curd
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Building Permit Application
Planning and Development services
Building and Code Regulation Division Commercial Residential X
1300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: Re-Roof
PROPOSED IMPROVEMENT LOCATION:
Address: �+1 1 f r+
Property Tax ID#: 54DI-10 1 D -02-01 __i'- ODD "4 Lot No. (D
Site Plan Name: =Al e_Y- �c rtflPX Block No.F—
ProjectName: 14cskoC;C Pie — Ei)LE
DETAILED DESCRIPTION OF WORK:
Re-Roof LA110cle- /36y41Ialkt-
Underlayment - y4C9-1-Y1C'Ir1bCcl'
Ridge Vent - e
New Electrical Meter Second Electrical Me er (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 Roof 4 Pitch
Total Sq. Ft of Construction:Z 46 1 Sq. Ft.of First Floor:
Cost of Construction:$ 4 oo Utilities: x Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name: Robert Donovan
Address: Company:Total Home Roofing
city:-j State: Address:_5114 W Okeechobee Blvd, Suite 201
Zip Code:�3AC1 S 7 Fax: city: West Palm Beach State:
Phone No. — Zip Code: 33417 Fax:
E-Mail: 1-ICeX4�1TIo Jan 11 . MYVI Phone No 321-452-9223
Fill in fee simple Title Holder on next page( if different E-Mail Christa0throofing.com
from the Owner listed above) State or County License CCC1330489
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: 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.
Signature of Ow Lessee/Contractor as Agent for Owner
STATE OF FLORIDA��m
COUNTY OF IiC�DI�' t
Sworn to(or affirmed)and subscribed befo a me of X Physical Presence or Online Notarization
this l5day of S-ems 20jg�j by
Robert Donovan
Name of person making statement.
Personally Known X OR Produced Identification
Type of Id tifi a ion Produced
AA1 A
(Sign ure of Notary Public-State of Florida)
w Michelle Thulisma
Commission No.44;Q 3g42-t (Seal) Notary Public
State of Florida
Comm#HH134514 t
Expires 5/25/2025
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