HomeMy WebLinkAboutPermit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Da(t�e: Permit Number:
61,5,
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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 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 3107 S 24th St, Fort Pierce, FL 34982
Property Tax ID#: 2428-603-0012-000-8 Lot No. 12 & 13
Site Plan Name: Block No. 1
Project Name: Reroof
DETAILED DESCRIPTION OF WORK:
1 Story Tear off and reroof installing insulation & tpo
New Electrical 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 Pitch
Total Sq. Ft of Construction: 1541 Sq. Ft. of First Floor:
Cost of Construction: $ 8,000 Utilities: Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Rose M Salinas Name: Calvin Lars Christensen
Address: 3107 S 24th St Company:Roof Doctors LLC
City:Fort Pierce State: FL Address: P.O. BOX 467
Zip Code: 34982 Fax: city: Jensen Beach State: FL
Phone No. E- Zip Code: 34958 _Fax:
Mail: Phone No 800-339-7326
Fill in fee simple Title Holder on next page (if different E-Mail Roofdoctorsfl@gmail.com
from the Owner listed above) State or County License CCC1326620
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:
`i
Zip: Phone: Zip: Phone:
! OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. i
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
j which conflicts with n applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please cont with our Homeowners Association and review our deed for any restrictions which may apply.
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j In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
I in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
I 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 faolure 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. f I
I Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
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with lender or an attorney before commencing work or recording our Notice of Commencement.
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4 ignature of Owner/Lessee/Contrac or as Agent for Owner
STATE OF FLORIDA
COUNTY OF Martin
Sworn to(or affirmed) and subscribed before me of X Physical Presence or Online Notarization
this day of NQVtV\A!2tK , 202�by
Calvin Lars Christensen
Name of person making statement.
A11
Personally Known X OR Produced Identification ���` �..• • �o
•
Type of Id tifica ' Produced ,�`` .•''�� iv '..
_� �,•.gyp Oc,�.l 02"��'.�/% I
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(Signature of Notary Public-State of Florida) P U a L I C
Commission No. (Seal) % � •• #G • ����`~
OFFLG���``
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE j
RECEIVED !i
DATE f'
COMPLETED
Rev 20 2 � it