HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 /4/22
Imo LUC HE _...,
Planning and Development Services
Permit Number:
Building Permit Application
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: SHINGLE REROOF
PROPOSED IMPROVEMENT LOCATION:
Address: 6754 Dickinson TERPort St Lucie, FL 34952
Property Tax I D #: 3415-706-0039-000-2
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
REMOVE EXISTING SHINGLE ROOF AND INSTALL A NEW SHINGLE ROOF
LOMANCO LOR-30 NOA# 19-1217.03; POLYSTICK IR-XE FL# 5259.1 (4.9)
OWENS CORNING DURATION FL#10674
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Residential X
Lot No.7
Block No. 2
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _Sprinklers _ Generator e/ Roof 5/12 Pitch
Total Sq. Ft of Construction: 4100
Cost of Construction: $ 16525
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height: 1 STORY
OWNER/LESSEE:
CONTRACTOR:
Name NICHOLAS ZAHTILLA
Name: ANDREW GRIFFIS
Address: 6754 DICKINSON TERR
Company:ALL AREA ROOFING & CONSTRUCTION
City: PORT ST LUCIE State:
Zip Code: 34952 Fax:
Phone No.440-488-2660
Address: 3921 S US HWY 1
City: FT PIERCE State: FL
Zip Code: 34982 Fax: 772-464-6600
Phone No 772-464-6800
E-Mail: NCZAHTILLA2@GMAIL.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 LicenseCCC1330649
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
Name:_
Address:_
City:
Zip:
Phone
State
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:_
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
x Not Applicable
State:
x Not Applicable
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
impr,Eyvements to your property. A Notice of Commencement must be recorded in the public records of St.
Luci //County and posted on the jobsite before the first inspee,ction. If you intend to obtain financing, consult
witklendtar or an attornev before commencing work or recbrdina vour Notice of Commencement.
SignVture dfOw`ne—r/ Lessee/tl// ractor as Agent for Owner Sigha"ture of Contraefor/Liden!fiyHolder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY 0FSTLUCIE
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this 4 day of JANUARY 2020 by
ANDREW GRIFFIS
Name of person making statement.
Personally Known x OR Produced Identification
Type o Identification
Pr
i
( at re of Notary Pub c- Spa;g of Florid
A1TH MASON
oCP BC
Comm�is 'ppn # GG 960757
Commission No. aP Ekpl�es�June20,2024
9jFOFF�op\ Bonded Thru Budget Notary Services
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COUNTER I REVIEW
DATE
RECEIVED
DATE
COMPLETED
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this 4 day of JANUARy 2020 by
ANDREW GRIFFIS
Name of person making statement.
Personally Known x OR Produced Identification
Type of, Identification
Produ ed
(Sir ature of Notary Public- Statr,4#,Florida )
�o ,,...,�1,� FAITH MASON
* * ' ion # GG 960757
Commission No. c� x`pires June20, 2024
9rFOF FL6P` Bonded Thru Budget Notary Services
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