HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/19/2021 Permit Number:
t 1 6u
0
v Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Re -Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 4104 Avenue R Fort Pierce, FL 34947
Property Tax ID #: 2406-114-0003-000-3 Lot No.
Site Plan Name: Fred Dunn III Block No.
Project Name: Fred Dunn III JOB Re -Roof
DETAILED DESCRIPTION OF WORK:
Re -Roof Shingle
I Indrlavment - Watherlock
Ridge Vent - Replaced
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
_ Electric _ Plumbing
Total Sq. Ft of Construction: 962
Cost of Construction: $ 10, 545.00
(Affidavit required)
_ Shutters _ Windows/Doors _ Pond
_Sprinklers _Generator X Roof 2 Pitch
Sq. Ft. of First Floor:
Utilities: ,(Sewer _Septic Building Height: 15'
OWNER/LESSEE: AIL
C
Name Fred Dunn III
Name: Robert Donovan
Address: 4104 Avenue R
Company: Total Home Roofing
city: Fort Pierce 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: iudith.duran(throofing.com
Fill In fee simple Title Holder on next page ( if different
from the Owner listed above)
E-mail Christaftthroofing.com
State or County License COC1330489
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:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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
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 attornev before commencirm work or recordins your Notice of Commencement.
Signature of Ow Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of X Physical Presence or _ Online Notarization
this � day of I AN' 20'� by
Robert Donovan
Name of person making statement.
Personally Known X OR Produced Identification sz071u11'dx3
Type of Identification Produced SSSLSL NN f,..
Y0I561wwoo A
u un4 411pnrW
i i..w XL�T7 �� sPuold to ams ollgnd lletou
(Sig re of Notary Public- State of Florida )
Commission No. + ru a Q (Seal)
REVIEWS I FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
ZONING
REVIEW
Notary Public State of Florida
Judith Duran
My Commiswon
IIII E%D.1111112025
SUPERVISOR I PLANS VEGETATION SEATURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW