HomeMy WebLinkAboutPermit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Z, l 10-l)��..
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: 4u44 cireenw000 Or
Property Tax ID #: 2428-702-0010-000-8 Lot No. 10
Site Plan Name:
Block No. 1
Project Name: Smith -Re- Roof
� DETAILED DESCRIPTION OF WORK:
RP-Rnof - Shingle
Underlayment - Weather Lock
Ridge Vent - Off Ridge Ventsure
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit— check all that apply:
Mechanical
Electric
Gas Tank
—Plumbing
Total Sq. Ft of Construction: 6709
—Gas Piping
_ Sprinklers
_ Shutters
_ Generator
Sq. Ft. of First Floor:
Windows/Doors Pond
X Roof 5 Pitch
Cost of Construction: $ 26,950.00 Utilities: _XSewer _Septic Building Height: 15'
OWNER/LESSEE:
CONTRACTOR:
Name Smith, Claudia
Name: Robert Donovan
Address: 4044 Greenwood Dr
Company: Total Home Roofing
city: Fort Pierce State: FL
Zip Code:34982 Fax:
Phone No. (646) 734-2951
Address: 5114 W Okeechobee Blvd, Suite 201
city: West Palm Beach Stater
Zip Code: 33417 Fax:
Phone No 321-452-9223
E-mail: cherylsmith35(cD_msn.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Christa(cbthroofinci.com
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 TITLEHOLDER: _ 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 Counttyy 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 the Florida Building
plans, 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.
.W x Notary Pudic slate of Florm
Signature of Ow Lessee/Contractor as Agent for Owner i Janice Hill
HH 133274
STATE OF FLORIDA ��) Ex irescomO5 4r
Expires nSR1/2025
COUNTY OF
Sworn to (or affirme) nd subscribed befgrg me of Physical Presence or Online Notarization
this
�dayof ()C k 20� by
Robert Donovan
Name of person making statement.
Personally Known X OR ProducedJdentification
Tyr I entification Pro aced (�
a
of Notary Public -State of Florida )
7iss
Comion No. (Seal)
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