HomeMy WebLinkAboutRE-ROOF PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1-2$-2022 Permit Number:
4Y, LL! L LL
Cc Ll LtUN.
.
i L� t L I Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential X
CBDG Funding
PERMIT APPLICATION FOR: REROOF
PROPOSED IMPROVEMENT LOCATION:
Address: 5758 TRAVELERS WAY FT PIERCE 34982
Property Tax ID #:
Site Plan Name:
Project Name:
10-503-0137-000-1
i DETAILED DESCRIPTION OF WORK:
REMOVE SHINGLE ROOF
Lot No.41
Block No. D
INSTALL PEEL & STICK UNDERL.AYMENT FL2569
INSTALL RIDGEVENT NOA NO. 19-1217.03
New Electrical Meter _ Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION: 1
Additional work to he performed under this permit —check all that apply:
_Mechanical ^ Gas Tank _ Gas Piping , Shutters _ Windows/Doors
Electric — Plumbing _ Sprinklers Generator x Roof 5112
Total Sq. Ft of Construction: 7439 _ Sq. Ft. of First Floor: 2439
Cost of Construction: $ 10900 Utilities: —Sewer _Septic Building Height: 8 FT
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name jnsnphinp T White
Name: RC}I AND WILEY
Address: 5758 Travelers Way
Company: SHORELINE ROOFING
City: FT PIERCE State: FL
Address:1973 SW GLENDALE STREET
Zip Code: 34987 Fax:
City. PORT ST LUCIE State: FL
Phone No. E-
Zip Code: 34987 Fax:
Mail:
Phone No 77220Q9565
Fill in fee simple Title Holder on next page (if different
E-Mail_ SHORE:LINEROOFING(&YAHOO.COM
from the Owner listed above)
State or County License
If value of construction is 2500 or more, a RfcoRveo Notice or Lommencement is requimu.
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 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 any applicable Homeowners Association rules, bylaws yr 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 con currency 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 Retard 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
uiith Icnrlpr nr an attnrnpv hPforf- rnmrnin.nrina work or recording vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agdnt for Owner
STATE OF FLORIDAC,
COUNTY OF , _icu� —
Swor ❑ (or affirm d) and subscribed before me of V Physical Presence or Online Notarization
#his day of , �C _ �0 by
Name of person making setement.
Personally Known '-%� OR Produced Identification
Type of Identification Produced
(Signature of Not r ublic- State of
BRANDY MOORE
commission No. Notary Public Florida
-State of
Commission # HH 108395
> �c My Commission Expiiea
May 09. 2025
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