HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1-4-2021 Permit Number:
L ` t` L1,Building Permit Application
Planning and Development Services
Building and Code Regulation division Commercial Residentiai
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: REROOF
PROPOSED IMPROVEMENT LOCATION.
Address: 5831 Moss CT Unit 3F Fort Pierce 34982
Property Tax ID #: 3410-507-0012-000-1
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
REMOVE SHINGLE ROOF
INSTALL PEEL & STICK UNDERLAYMENT FL2569
Lot No._
Block No.
INSTALL SHINGLE FL10674 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
_ Eiectric _ Plumbing _ Sprinklers _ Generator X Roof 5/12 Pitch
Total Sq. Ft of Construction: 1424
Cost of Construction: $ 6975
Sq. Ft. of First Floor: 1424
Utilities: —Sewer —Septic
Building Height: 8 FT
OWNERAESSEE:
CONTRACTOR:
Name Patrick J Costello
Name: ROLAND WILEY
Address:5831 Moss CT Unit 3F
Company: SHORELINE ROOFING
City: FORT PIERCE StatefL_
Zip Code: 34982 Fax:
Phone No. E-
Address: 1973 SW GLENDAI_E STREET
City: PORT ST LUCIE State: FL
Zip Code: 34987 Fax:
Phone No 772-260-9565
E-Mail SHORELINEROOFING@YAHOO.COM
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County license CCC1331170
If value of construction is 25110 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
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 instanation as muicaieu.
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 yobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
Signature 63 ❑wner/ Lessee/Contraaor as Agent fo owner
STATE OF FLORIDA y
COUNTY OF
Swor� o (or affir t and subscribed bef e,me of �` Physical Presence or online Notarization
this day of C �[ ZO y
Name of person making statement.
Personally Known I' OR Produced Identification
Type, of identification Produced
(Signature of Notary ublic- State of
`` { .� r • �� ,�R;p;',, BRANDY MOORE
Commission No I� �i5=Narary Fuiilir_-State of Florida
Commission # HH 10839E
My Commis ion E.-Poe
May 09, 202
REVIEWS j FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
SUPERVISOR I PLANS i VEGETATION ' SEA TURTLE
REVIEW I REVIEW ! REVIEW
REVIEW
MANGROVE
REVIEW