HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/4/21 Permit Number:
U c CO) ° D t�' 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: SHINGLE REROOF
PROPOSED IMPROVEMENT LOCATION:
Address: 3103 KINGSLEY DR FT PIERCE, FL 34946
Property Tax ID #: 1432-807-0028-000-9
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
REMOVE EXISTING SHINGLE ROOF AND INSTALL A NEW SHINGLE ROOF
LOMANCO OMNI LOR-30 NOA# 19-1217.03; POLYSTICK IR-XE FL# 5259.1 (4.9)
GAF TIMBERLINE HDZ NOA# 19-0312.04
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: 1900
Cost of Construction: $ 9600
_ Generator
Sq. Ft. of First Floor:
Lot No. 270
Block No.
Windows/Doors _ Pond
Y Roof 4/12 Pitch
Utilities: —Sewer —Septic Building Height. 1 STORY
OWNER/LESSEE:
CONTRACTOR:
Name GRAPE LEAF PARK LLC
Name: ANDREW GRIFFIS
Address: PO BOX 8
Company: ALL AREA ROOFING & CONSTRUCTION
City: FT PIERCE State:
Zip Code: 34954 Fax:
Phone No. 954-554-8525
Address:3921 S US HWY 1
City: FT PIERCE State: FL
Zip Code: 34982 Fax: 772-464-6600
Phone No 772-464-6800
E-Mail: NABILKISHK@AOL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail FAITH@ALLAREAROOFINGFTP.COM
State or County License CCC1330649
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: x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x 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
improv,iftents to your property. A Notice of Commencementmust be recorded in the public records of St.
Lucie unty and posted on the jobsite before the first inspe ion. If you intend to obtain financing, consult
with nder or an pttornpy b fore commencing work or recglrdineour Notice of Commencement.
A4 J_ A 714/�
Sig ure of Owner/ Lessee/C nt ctor as Agent for Owner
Signature of Contractor/Lice H er
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST LUCIE
CO UNTY OF ST LUCIE
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
x Physical Presence or Online Notarization
this 4 day of NOVEMBER , 2021 by
this 4 day of NOVEMBER , 2021 by
ANDREW GRIFFIS
ANDREW GRIFFIS
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Typ f Identification
Type of Identification
o ed
Produ ed
re of Notary PublicP f FlorikiH MASON
(Sig ature of Notary Public- State -of Florida )
Com issi # GG 960757
FAITH MASON
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Commission No.
ane 20,2024
Commission No.
`Lyjqj sion#GG960757Ex
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9lFOF FL°P� Bonded Thru Budget Notary Services
ExpiresJune 20, 2024
9fFOF FL°Q`oe Bonded Thru Budget Notary Services
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