HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11 /19/2021
Permit Number:
9Vo L Ig
V Building pp Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Re -Roof
PROPOSED IMPROVEMENT LOCATION:
X
Address: 11003 Ridge Ave Fort Pierce, FL 34982
Property Tax ID #: 3532-503-0066-000-7 Lot No. 7
Site Plan Name: Fuller, Mary (POA) & Marjorie Bledsoe Block No. 5
Project Name: Fuller, JOB Re -Roof
DETAILED DESCRIPTION OF WORK: I
Re -Roof Shingle
Underlavment - Watherlock
Ridge Vent - Replaced
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 _K Roof 4 Pitch
Total Sq. Ft of Construction: 3355
Cost of Construction: $ 13, 889.00
Sq. Ft. of First Floor:
Utilities: X Sewer _Septic Building Height: 15'
OWNER/LESSEE:
CONTRACTOR:
Name Fuller. Mary (POA) & Madorie Bledsoe
Name: Robert Donovan
Address: 11003 Ridge Ave Port St Lucie, FL 34982
Company: Total Home Roofing
city: Port St Lucie State: FL
Zip code: 34982 Fax:
Phone No. (813-412-9151
Address: 5114 W Okeechobee Blvd, Suite 201
city: West Palm Beach Stater
zip Code: 33417 Fax:
Phone No 321-452-9223
E-Mail:_ ludith.duran(aithrooflng.com
Fill In fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Christa0throofing.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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
City:
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 bylaws
rules, or and covenants that may restrict or prohibit such
structure. Please consult wrth 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 attorneybefore commencingwork or recordin our Notice of Commencement.
FlondaSignature of Ow L ntractorasAgentforOwner NotaryPUDI1cStaeof
udith Duran
°97on
STATE OF FLORIDA i5 559
.
:4�aj'cpltitti2o2COUNTYOF H
i
Sworn to (or affirrro) and subscribed before me of X Physical Presence or _ Online Notarization
this a day of l)(IC 2011 by
Robert Donovan
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identific ion Produced
(Signature of otary Public- State of Florida )
Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev