HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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L. c `' ` b A, - Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential xxxxxxxxxxx
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772)462-1578
PERMIT APPLICATION FOR:RE-ROOF
PROPOSED IMPROVEMENT LOCATION:
Address: 14219 DULCE REAL FT. PIERCE, FL 34951
Property Tax ID#: 1306-500-0342-000-6 Lot No.4
Site Plan Name: Block No. 74
Project Name:
DETAILED DESCRIPTION OF WORK:
REMOVE AND REPLACE ROT- INSTALL S/A TITANIUM PSU-30 UNDERLAYMENT- INSTALL 26 GA GULF RIB
METAL
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 _Windows/Doors _ Pond
Electric _Plumbing _Sprinklers _Generator Roof 5 Pitch
Total Sq. Ft of Construction: 3,700 Sq. Ft. of First Floor:
Cost of Construction: $ 16,850 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name CAROL WORTHLEY Name:JOE BAKER
Address:14219 DULCE REAL Company:BIG LAKE ROOFING &REPAIRS
City: FT. PIERCE State:_ Addres5:2699 NW 16TH BLVD.
Zip Code: 34951 Fax: City: OKEECHOBEE State.FL
Phone No.207-317-9097 Zip Code: 34972 Fax: 863-763-7662
E-Mail: Phone No863-763-7663
Fill in fee simple Title Holder on next page(if different E-Mail BIGLAKEROOFING@YAHOO.COM
from the Owner listed above) State or County LicenseCCC046939
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: 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 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
with lender or an attorney before commencing work or recording our Notice of Commencement.
Signature o Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID ,/n 'r ,^ _e COUNSTATY OF OY Oj�� �P—P
COUNTY OFC�(�jV`�1
SWn to(or affirmed)and subscribed before me of SvKogn to(or affirmed)and subscribed before me of
(—Physical Presence or Online Notarization �hysical Presen a or Online Notarization
this�!t'i�`ay of 2e2&by this a�C7 my of 'zG'"
off- odd
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-Stat (Signature y to of_F _�F ��:�.�.�_�� Si nature of Notary Public-Sta
;•',:��uo� HEATHEREDtiNARDSCNNI W, HEATHE:I�EWIARDSO�!
Commission No. = `` ' ¢c
YCOMII*Abl4GG 1�185 Commission No, MyCoMM�§'g4Q#GG 15185
EXPIRES:May 21,2022 , ;1 - EXPIRFS:May 21,
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20