HomeMy WebLinkAboutPermit App (2)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/15/21 Permit Number:
LT4o
c: u u La 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: METAL/MODIFIED REROOF
PROPOSED IMPROVEMENT LOCATION:
Address: 6004 BALSAM DR FT PIERCE, FL 34982
Property Tax ID #: 3402-610-0540-000-3
Site Plan Name:
Project Name:
Lot No.8
Block No. 88
DETAILED DESCRIPTION OF WORK:
REMOVE EXISTING SHINGLE/ MODIFIED ROOF AND INSTALL A NEW q1Q�dj//MODIFIED ROOF
.I;iJ-��"1 ��<•i"t(.� `�yl �;O `�i�(��-l.c.ZJ__�L fd ������% ��1. l /) � :l ��-l'i�Li� /�'S`� ����i-(.; f� �;�5•�Cr� 1.1
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 _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator X Roof 4.5112 & .25112 Pitch
Total Sq. Ft of Construction: 2400 Sq. Ft. of First Floor:
Cost of Construction: $ 16800 Utilities: —Sewer —Septic Building Height: 1 STORY
OWNER/LESSEE:
CONTRACTOR:
Name THOMAS FUHR
Name: ANDREW GRIFFIS
Address:6004 BALSAM DR
Company:ALL AREA ROOFING & CONSTRUCTION
City: FT PIERCE State: ► L_
Zip Code. 34982 Fax:
Phone No. 607-368-8162
Address: 3921 S US HWY 1
City: FT PIERCE State: FL
Zip Code: 34982 Fax: 772-464-6600
Phone N0772-464-6800
E-Mail; CATHERINEANN29@YAHOO.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
imprc�iemen s to your property. A Notice of Commencement must be recorded in the public records of St.
Luci County and osted n the jobsite before the first inspecc�tion. If you intend to obtain financing, consult
lender
wit r an ttornf b fore commencing work or recQ ding your Notice of Comme cement.
bt4�j A, J-41111--
Signature of Owner/ Lessee/Co r or as Agent for Owner
Signature of Contractor/License H er
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OF STLUCIE
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 15 day Of DECEMBER . Z020 by
this 15 day of DECEMBER 2020 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
Type of Identification
Type of,ldentification
Produced
Produced,
\�A,
11 bl
I,
(Sig nat re of Notary Public`- Sta;� of Florida
AITH MASON
( gn Are of Notary Public- State of Florida )
2°t
C ion # GG 960757
Commission No. * y* ����
xpire June 20, 2024
0stv Pue FAITH MASON
�° .• •.�'�
Commission No. * Comrr��agMGG960757
r°e
9rFOF Ft,a� Bonded Thru Budget Notary Services
,� c� Expires June 20, 2024
i1B
°Q� Bonded Thru Budget Notary Serv'wes
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