HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: 6I l I ' ca C
11
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 Yes
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID #: 3 4VZ " Lei 0 - QZ / / " CM - 2 Lot No.Vp
Site Plan Name: N/a Block No.�
Project Name: N/a
Setbacks Front N/a Back: N/a Right Side: N/a Left Side: N/a
DETAILED DESCRIPTION OF WORK:
We will tear off the existingiroofing down to the plywood, Re -nail the deck to the current code and Re-roofVvt.Vyt &4
Skl tc 11 IrA4
FI+C'V'. %+/I Z
CONSTRUCTION INFORMATION:
itiona wor to e e orme under this permit— checK all apply:
E1HVAC 0 Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
11 Electric ❑ Plumbing ❑Sprinklers Generator E Roof
Total Sq. Ft of Construction: 2
Cost of Construction:
S . Ft- of First Floor: N/a
Utilities: Sewer E]Septic
Building Height: N/a
OWNER/LESSEE:
CONTRACTOR:
Name
Name: Christopher Collins
Address: ��
Company: Collins Roofing Inc
City: State:
Address: PO Box 12867
Zip Code: lqqq2 Fax: N/a
City: Fort Pierce State: FL
Phone No. N/a
Zip Code: 34979 Fax: 772-489-6505
E-Mail: N/a
Phone No. 772-201-1352 or 772940-8607
Fill in fee simple Title Holder on next page (if different
E-Mail: Collinsroofinginc@gmail.com
from the Owner listed above)
State or County License: CCC-058011
If value of construction is S2500 or more, a RECORDED Notice of commencement is regwrea.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: d_ Not Applicable
MORTGAGE COMPANY: d_ Not -Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: d_ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 accordance with the approved plans, the Florida Building Codes and St. Lucie C tY Ame
The followin ilding ermit.a . a io are exempt from undergoing a fu oncurrency re
accesso structures, s im ng pools, fen es, walls, signs, screen rooms d accessory uses
ING TOO ER: Your failure o Record a Notice of
I provements y ur property. Notice of Commenc(
efore the i ection. I tend to obtain fina
commen ' w or re In our Notice of Com er
ure o % weer/ Le seeJ ent
STATE OF FLORIDA
COUNTY OF l ei
The f rgoing instrument was acknowledged before me
this day of 20 `� �by
(Name of person acknowledging)
Person0y Known _
Type of Identificatic
Commission No.
Revised 07/1
fi Public- State of Florida
OR Produeedlde
t must
consul
perform the work
iew om additions,
other non-resid ntial use
It in your payi g twice for
d ane
er or,�rl/att ney before
STATE OF FLORIDA 'rr
COUNTY OFi�
The forgoing instrument was acknowledged before me
this L day of / [ f)'� , 20 by
(Name of person acknowledging )
- �/Lej
(Signatur o to Pu I'c- State of Florida )
Personally Known adLced�de€ntifioatbn -
Type of Identification , rodµa®d, CASEY D FRENC�F —
Not" Public - State of Florida
My Clxpires De
c 1, 2017 t Commission No.
Commission # FF 069924
Notary Public - State o ortua
My Cor(geirpires Dec 1, 2017
Commission # FF 069924
R�miwi Throvah National Notary Assn.
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