HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/04/22 Permit Number:
91ri. Ll? ALL
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 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED I-MPROVEMENT LOCATION:
Address: 7908 KENWOOD RD Fort Pierce, FL 34951
Property Tax I D #: 1301-605-0237-000-4
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace flat roof
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Lot No. 5
Block No. 49
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 1/12 Pitch
Total Sq. Ft of Construction: 533 Sq. Ft. of First Floor: 2,500
Cost of Construction: $ 4,000.00 Utilities: -Sewer _Septic Building Height: 15ft
OWNER/LESSEE:
CONTRACTOR:
Name Bradley Peterson
Name: Christopher Thomas
Address: 7908 Kenwood Rd
Company: Superior One Roofing
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No. 301-514-2455 E-
Address: 54 West ILLIANA ST
City: Orlando State: FL
Zip Code: 32806 Fax:
Phone No 407-317-6185
Mail: bradleypeterson67910)amail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail flpermits@superioroneroofing.com
State or County License CCC1331538
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
WARNING TO OWNER:
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.
IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Must be signed by owner/Agent and applicant:
(Signature of contractor)
State of Florida, County of
A&ed to and subscribepd before methis .20� by 1•.�IYIJ'
p m rn b or s produced
as identification.
n n.
Notary Signature:
0 CASEY R ELLIS
State of Florida - Notary Public
Notary (print name) Commission # HH 49916
(Signature of Owner or Agent (including coo bactor))
State of Florida, County of l
Affirmed to and subscribed before me this d/
20 M, by .from,
personally known to m z who has produced
as identification.
Notary Signature: Q
CASEY R ELLIS
State of Florida - Notary Public
Notary (print name) Commission # HH 49E
Construction docume c mpany is application. The Florida energy code subn2ffRM05n7es Tan part of this
plan and must pass final inspection. "Notice: In addition to the requirements of this permit, there may be additional restrictions
applicable to this property that may be found in the public record of this county, and there may be additional permits required
from other governmental entities such as waste management district, state agencies, or federal agencies. "SIGNATURE OF THE
APPLICANT MUST BE NOTARIZED. If owner builder, applicant must sign in person. BUILDING PERMIT includes:
Building, Electrical, Plumbing, Mechanical, and Sewer only. All other trades require separate applications.
Asbestos compliance: It is the owner's or operator's responsibility to comply with section 469.003, Florida Statutes, and
to notify the Department of Environmental Protection of his or her intentions to remove asbestos, when applicable, in
accordance with state and federal law.
FEE SIMPLE TITLEHOLDER, BONDING COMPANY AND MORTGAGE LENDER INFORMATION IS REQUIRED WHEN
THE AGGREGATE VALUE (TOTAL COST OF ALL IMPROVEMENTS AND NOT JUST WORK AUTHORIZED BY THE
INDIVIDUAL PERMIT) IS$2500 OR MORE (EXCEPT HVAC REPAD2/REPLACEMENT<$7500). PLEASE ADDRESS ALL
ITEMS.
Fee Simple rrtleholder's
Name (if other than owner)
Address:
City:
Mortgage Lender's
Name:
Address:
❑ Same as Owner
❑ Not Applicable
Bonding Company ❑ Not Applicable
Zip: City: State: Zip:
Slate: Zip:
OFFICE USE ONLY
Is the property located in a Special Flood Hazard Area (floodplain) per the current Flood Insurance Rate Map (FIRM)
Flood Zone:
Permit Fee
State Surcharge $
Subcontractor $
Reviewed by:
Total Amount Due at Issuance
Remarks
❑ Yes ❑ No
Determination:
Other
$
Plan Review Fee
$
Other
$.
Routing Fee
$
Flood Review Fee
$
Other
$
Active Code Violation O Yes ❑ No
Case #
Case Type
Reviewed by Date Final Check Date
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