HomeMy WebLinkAboutPermit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
0
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Re -Roof
PROPOSED IMPROVEMENT LOCATION:
Residential X
Address: 5501 Seagrape DR Fort Pierce, FL 34982
Property Tax ID #: 3402-609-0046-000-6 Lot No.
Site Plan Name: Judith Olisky
Block No.
Project Name: Judith Olisky
DETAILED DESCRIPTION OF WORK:
Tear off existing roof and replace with new Standing Seam Metal Roof system
SSM (FL25621-R2), Titanium 30 (FL11602-R11)
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: 2soo
Cost of Construction: $ ZZ, S519 - QO
Generator
Sq. Ft. of First Floor:
. Windows/Doors r _ Pond
'k Roof f 12 Pitch
250Cs
Utilities: —Sewer _Septic
Building Height: 15f+
OWNER/LESSEE:
CONTRACTOR:
Name Judith Olisky
Name: Dee Keihn
Address: 5501 Seagrape DR
Company: PDKRoofing.lnc
P Y�
Address:1761 SW Biltmore Street
City: Fort Pierce State: VL
Zip Code: 34982 Fax:
City: Port Saint Lucie State: FL
Phone No. (772)528-0113
Zip Code: 34984 Fax:
Phone No (772)528-0113
E-Mail: PDKRoofing.lnc@gmail.com
Fill in fee simple Title Holder on next page ( if different
E-Mail PDKRoofing.lnc@gmail.com
from the Owner listed above)
State or County License CCC1331408
n vciue ui wnsirucoun is c3uu or more, a Ktr UKutU 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: I
DESIGNER/ENGINEER: Not Applicable
Name:_
Address:
City:
Zip:
Phone
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
tate:
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 is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your home Owners 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
witMIender or an attornev before commencing work or recording your Alotipe of Coimmencement.
Signs -TO -re of OwrWIT Lessee/ ontractor as Agent for Owner
Signit—ure-of Contras or/License Hbl er
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S1r . l-UCtQ,
COUNTY OF ST. L.tICtE,
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
)( Physical Presence or Online Notarization
X Physical Presence or Online Notarization
this 3 day of �anua..h_ _� 2020 by
this day of a 2020 by
Name of person making statement.
Name of person making statement.
Personally Known o<
Type of Identification ;t'�"i :-Type
Personally KnownWDERAGI�IRRE
of IdenISSiON#GG234811
Produced .; ;�:► yCOMMISSION#GrGy�2y3y4811
producedlRE8:July
4,2022
BondedThruNotaryPubloUnderwriters
ORR S: July4,2Q22
otary Pubk tinder..,
+�6
(Signature o of ry Publt State of Florida)
Signature of Not ry P� ublic ate of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
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REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20