HomeMy WebLinkAboutREROOF PERMIT APPLICATION - 5966 TRAVELERS WAY All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11-17-2021 Permit Number:
Si, La CIL
`- ' ` i` LL, 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 CBDG Funding
PERMIT APPLICATION FOR:REROOF
PROPOSED IMPROVEMENT LOCATION:
Address: 5966 TRAVELERS WAY
Property Tax ID#: 3410-503-0107-000-2 Lot No. 11
Site Plan Name: Black No. D
Project Name:
DETAILED DESCRIPTION OF WORK:
REMOVE SHINGLE ROOF
INSTALL PEEL S STICK UNDERLAYMENT FL2569
INSTALL RIDGEVENT NOA NO. 19-1217.03
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 5112 Pitch
Total Sq. Ft of Construction: 1984 Sq.Ft.of First Floor: 1984
Cost of Construction:$_10,000 Utilities: —Sewer _Septic Building Height: 8 FT
OWNERAESSEE: CONTRACTOR:
Name Allan Michael ❑inizio Name: ROLAND WILEY
Address. 255 6th ST Company: SHORELINE ROOFING
City: LAUREL State:NY Address:1973 SW GLENDALE STREET
Zip Code: 11948 Fax: City: PORT ST LUCIE State: FL
Phone No. E- zip Code: 34987 Fax:
Mail: Phone No 772-260-9565
Fill in fee simple Title Holder on next page(if different E-Mail SHORELiNEROOFING n@YAHOO.COM
from the Owner listed above) State or County License CCC1331170
if value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
IL If value of HAVC is$7,S00 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 conflicts with any applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such
structure-Please consult with your Homeowners 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 attorn ey before com men cin work or record in our Notice of Commencement.
� •I . .
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 1 r -C-
Sword to(or affirn?ed).and subscribed before me of Physical Presence or Online Notarization
this I day of 20—by
Name of person making sotement.
Personally Known OR Produced Identification
Type pf identification Produced
(Signature of Notady Public-State
r 13RANDY MOORE
Commis5ion No. " 1 [ �� Not I y Publrc Stare of Florida
Commission u HH 106395
-� = My Commission Expires
May 09, 2025
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