HomeMy WebLinkAboutPermit App - Dunn - Ave R All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
V � ;�- 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: 4104 Ave R
Property Tax ID#: 2406-114-0003-000-3 Lot No. 17&18
Site Plan Name: Block No. 107A
Project Name: Paylor- Re-Roof
DETAILED DESCRIPTION OF WORK:
RP-Rc)nf OhAi Mt -Tapered
- Weather Lock
av
New Eledic�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 . Qs Pitch
Total Sq. Ft of Construction: 952 Sq. Ft.of First Floor:
Cost of Construction: $ 10,545.00 Utilities: X Sewer _Septic Building Height: 15'
OWNER/LESSEE: CONTRACTOR:
Name Fred Dunn Name: Robert Donovan
Address: 4104 Ave R Company:Total Home Roofing
city: Fort Pierce state: FL Address:5114 W Okeechobee Blvd,Okeechobee Blvd, Suite 201
Zip Code:34947 Fax: city: West Beach State:State: FL
Phone No. (772) 971-4846 zip Code: 33417 Fax:
E-Mail: dunn23dat@aol.com Phone No 321-452-9223
Fill in fee simple Title Holder on next page(if different E-Mail Christa throofing.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 attorneybefore commencin work or recordin our Notice of Commencement.
Signature of Ow Lessee/Contractor as Agent for Owner
STATE OF
COUNTY OFORIDA /__
4�'Y/T
Swor t (or affirmed an subscribed bef a me of X Physical Presence or_Online Notarization
this day of 20 0 by
Robert Donovan
Name of person making statement.
Personally Known X OR Produced Identification • Nmry Puck State o f Florida+" 4
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Type of Identification Produced E vCi es OM4ri HH o25 133274
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(Signature of Notary Public-State of Florida)
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Commission No. (Seal) szoznrrsoae,p.a f
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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