HomeMy WebLinkAboutPermit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Re -Roof
PROPOSED IMPROVEMENT LOCATION:
Residential X
Address: 3494 Roselawn Blvd
Property Tax ID ff: 2428-702-0010-000-8 Lot No. 10
Site Plan Name: Block No. 1
Project Name: Simpson Angie -Re -Roof
DETAILED DESCRIPTION OF WORK:
Rp-Rnnf - Shingle /Flat
I Inderlayrtlent -Weather Lock
Ridge Vent - OC Ridge Vents
New Electrical Meter Second Electrical
(Affidavit required)
CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit —check all that apply:
_Mechanical
_ Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction: 2816
—Gas Piping
Sprinklers
Shutters
_ Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
_k Roof 3 Pitch
Cost of Construction: $ 12,200.00 Utilities: ]( Sewer _ Septic Building Height: 15'
OWNER/LESSEE:
CONTRACTOR:
Name Simpson, Angie
Name: Robert Donovan
Address: 3494 Roselawn Blvd
Company:Total Home Roofing
City: Fort Pierce state: FL
Zip code:34982 Fax:
Phone No. (717) 514-0110
Address: 5114 W Okeechobee Blvd, Suite 201
city: West Palm Beach Stater
Zip Code: 33417 Fax:
Phone No 321-452-9223
E-mail: apsimpson18(aDgmail.com
Fill in fee simple Title Holder an next page (if different
from the Owner listed above)
E-mail Christalothroofina.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 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 L ntractor as Agent for Owner M'Al& Notary Public Stets o1 Florida
Jessica Hill
Commission 133274
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STATE OF FLORIDA O d� Expires OSR4l202525
COUNTY OF
Swor (or affir� a d subscribed bef me of X Physical Presence or _ Online Notarization
this day of �! 1Ci'� . 20 by
Robert Donovan
Name of person making statement.
Personally Known x OR Produced Identification
Type entific Ion Produced
(Si o Notary Public- to of Florida )
Commission No. (Seal)
REVIEWS
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DATE
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DATE
COMPLETED
ev5/20/21