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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: RFDEiVRD Permit Number:c2Q J p,u -6f)
pe°`e county#M' —�
Vdilding Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential XXX
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:re-roof
.PROPOSED"IMP,
ROVEMENT LOCATLON {.
Address: 390 Baysinger Ave., Fort Pierce, Florida
Property Tax ID#: 340350101860001 Lot No.40 &41
Site Plan Name: Block No. 7
Project Name:
DETAILED DESCRIPTION OF WORK
remove exisiting shingle roof, re-nail to code, dry in with peel-n-stick underlayment, and install 26 ga
crimp metal rooting system. ft r— �t�h
b cs-S cry COLO CA
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
_Electric _Plumbing _Sprinklers _Generator Roof JZ Pitch
Total Sq. Ft of Construction: 792 Sq. Ft.of First Floor:
Cost of Construction:$ 5,800.00 Utilities: _Sewer _Septic Building Height: 8
OWNER/LESSEE: CONTRACTOR;,
Name Lana Morrow, Lisa Yuill Name: Richard Newland
Address: 1991 Lacelle St., Company: Richie the Roofer& Co. Inc.
City: Plantagenet, ON_KOB 1 LO, Canaggte:_ Address:903 13th SW
Zip Code: Fax: City: Vero Beach, FI State:
Phone No. Zip Code: Fax:
E-Mail: Phone No 772-473-6197
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
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.
t
DESIGNER/ENGINEER: ,Not Applicable MORTGAGE COMPANY: —Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
-Zip: Phone Zip: Phone:
r 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 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 conflicts with an 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 jobsite 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.
ignature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORID
COUNTY OF - - � — - -
Swor to(or affirmed and subscribed before me of �hysical Presence or Online Notarisation
this or
of 1 20 Q by
Name of person making statement.
Personally Known OR Produced Identification
Type of Idantification Produced
M o'0 dot a 'i
(Signature of Notary Public-State of Florida) ;
++�� i Notary public State o
a- f Florida
Commission No. X)l Seal) , _ Amanda?Sanderson
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
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