HomeMy WebLinkAboutPermit Application 11855 Appaloosa - Feb 4 2022 - 12-08 PMAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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
PERMIT APPLICATION FOR: Re -roof Shingle
PROPOSED IMPROVEMENT LOCATION: —_ I
Address: 11855 Appaloosa Court, Port St Lucie, FL 34987
Property Tax ID #: 35527
Site Plan Name: PONY PINES -UNIT ONE BLK A LOT 24 (1.91 AC) (OR 3134-1745; 3168-1984)
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace existing shignle roof with new shingle roof. Using self -adhered underlayment for secondary water barrier.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters ^ Windows/Doors
Electric ` Plumbing _ Sprinklers _ Generator V, Roof
Total Sq. Ft of Construction:
29,433.59
Cost of Construction. $
OWNER/LESSEE:
NameCathy Gaspar
Sq. Ft. of First Floor:
Utilities: Sewer _Septic
Address: 11855 Appaloosa Court
City: Port Saint Lucie State:FIL
Zip Code: 34987 Fax:
Phone No. 772-224-9686 E-
Ma il: gaspargirl27@aol.com
Fill in fee simple Title Holder on next page (if different
From the Owner listed above)
Lot No.24
Block No.
I
I�
Pond
Pitch
Building Height: 1 Story
CONTRACTOR:
Name: Cody Rhea
Company: FIXD Roofing
Address: 5870 Mustang Circle
City: Fort Pierce State: FL _
Zip Code: 34987 Fax:
Phone N0772-618-3493
E-Mail fixdroofing@gmail.com
State or County LicenseCCC1332497
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:
'DE SIGNER/ENGINEER: Not
Name: — Applicable
Address:
City: State:
Zip: one
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: ✓ Not Applicable
Name:
Address:
City: State:
Zip: ___: Phone:
BONDING COMPANY: ✓ Not Applicable
Name:
Address:
City:
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 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, perfornrthe 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.
Signature of C - or - Owner Builder as applicable
STATE OF FLORIDA`
COUNTY OF
Sworn tp (or affirmedLand subscribed before me of �ysical Presence or Online Notarization
this j day of 20by �;6%k 1—",n'rt t�
Name of person making statement.
Personally Known OR Pro uced Identification
Type of Identification Produced `
(Signature of Notary PuQblic- State of FloL.27;
Commission No. k 1 (Seal)S Public
PASCAL
Public-StatcofFlond.:
mission 4 GG 195t370
m. Expires Mar 13, 2022
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