HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1-21-2022.
Permit Number:
Lu c l
L� 2 L Li`l_-!'
L= L L, LL 1, Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
Q
PERMIT APPLICATION FOR: REROOF
PROPOSED IMPROVEMENT LOCATION:
Address: Pierc
Property Tax ID #: 3410-503-0095-000-4 Lot No. Block No..
C
Site Plan Name:
Project Name:
i
DETAILED DESCRIPTION OF WORK:
REMOVE SHINGLE ROOF
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
Electric _ Plumbing Sprinklers — Generator x Roof 5112 Pitch
Total Sq. Ft of Construction: 2440 Sq. Ft. of First Floor: 2440
Cost of Construction: $ 10,000 Utilities: , Sewer _ Septic building Height: $ FT
OWNER/LESSEE:
Name MIKE HAWEO
Address: 5765 Travelers WAY
City: FORT PIERCE StateFL
Zip Code: 34982 Fax:
Phone No. E-
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name:
ROLAND WILEY
Company: SHORELINE ROOFING
Address1973 SW GLENDALE STREET
City: PORT ST LUCIE State: FL
Zip Code: 34987 Fax:
Phone N❑ 772-260-9565
E-Mail SHORELINEROOFING YAHOO�
State or County License CCC1331170
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
MORTGAGE COMPANY: r Not Applicable
Name:
Name:
Address:
State:
Address:
City: State:
City:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
zip: Phone:
.L_ . .6 . A :...r�11zri-n me ine4iratMi
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to ootasn a pears?` ►u a wi m o, �•� �• - -- - -----
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, wa11s, 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
i0th lender or an attorney before commencingwork or recording our Notice of Commencement.
J1�I�
Signature of Owners Lessee�Cantra r as nt for owner
STATE OF FLORID
COUNTY OF �C
Swo to (or affirn�) and subscribed bet" me of ✓ Physical Presence or Online Notarization
thiMr day of I. ')f � 7- by
Name of person making spatemeaLl
Personally Known OR Produced Identification
Type of Identification Produced
(Signature ofN to Public -State BRANDY MODI�E
.,,�„ .
i; �bA P�'r,�
1�_.' �_i4otary Fultiic state of Flor,da
Commission N ` { o_ Comm{sslan # HH tf8395
My Commission [txure5
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DATE
RECEIVED
DATE
COMPLETED