HomeMy WebLinkAbout#44681 - Southard, Nicholas Application.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/19/2021 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Re -Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 1114 Percival ST Fort Pierce, FL 34982
PropertyTax ID #: 3404-501-0638-000-8 Lot No. 17
Site Plan Name: Nicholas Southard Block No.
Project Name: Southard, JOB Re -Roof
� DETAILED DESCRIPTION OF WORK:
Re -Roof Shingle
Underlavment - WeatherLock
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping
_ Electric _ Plumbing _Sprinklers
Total Sq. Ft of Construction: 2437
Cost of Construction: $ 15, 695.00
OWNER/LESSEE:
Name Nv:h, 'as Southard
Address:_1114 Percival ST
_Shutters _ Windows/Doors _ Pond
_Generator _kRoof 6 Pitch
Sq. Ft. of First Floor:
Utilities: -XSewer _Septic Building Height: 15'
city: Pori SI Lucie State: FL
Zip Code: 3l 982 Fax:
Phone No. (813-412-9151
E-mail: ludith.duran0throofino.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Robert Donovan
company: Total Home Roofing
Address: 5114 W OkeechobeeOkeechQbee Blvd, Suite 201
city: Nest Palm Beach State:_
Zip Code: 33417 Fax:
Phone No 321-452-9223
E-Mail Ch rista (a)th roofing. com
State or County License CCC1330489
.. • W...V.al1.WV1..° law yr more, d ncwnucu rvotice or 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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 attorne before commencin work or rcordin our Notice of Commencement.
Signature of Ow Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Sworn tg (or affirmed) and subscribed before me of X Physical Presence or_ Online Notarization
this .dayof Fah 2022_ by
Robert Donovan
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification Produced
(Signatur otaiy Public-St—ateof Florida )
Commission No. I l { S S 1 Seal Notary Public State of Florida
( ) Judith Duran
My Commission
=111-11111MI HH 197559
Exp.1111112025
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