HomeMy WebLinkAboutPermit Application.pdfAIIAPPLICABLE INFO MUST BE COMPLETED FOR APPTICATION TO BE ACCEPTED
Date:Permit Number:
Building Permit Application
Planning ond Development Services
Building and Code Regulation Division
840 Virginia Avenue, Fort pierce FL 34gg2
Phone: {7721 462-7553 Fax: (772lr 462-LS7B
Commercial Residential X
CBDG Funding
Propertyrax ID #:p!99-f 1 Q004-000-7 Lot wo. '12
Site Plan Name:Block No. 1
Project Name:
roof and renail MTS Plus self modified bitumen shi
underlayment. lnstall lKo cambridge dimensional shingles.
New Electrical Meter Second Electrical Meter (Affidavit required)
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows,/Doors _ Pond
Pitch_ Electric _ Plumbing _ Sprinklers _ Generator
Sq. Ft. of First Floor:
X Roof 5112
Total Sq. Ft of Construgl;sn. 4700
Cost of Construction: 5 26,400.00 Utilities: _ Sewer _ Septic Building Height:
lfvalueofconstructionis2500ormore,aREcoRDEDruoticeofco@
lf value of HAVC is 57,500 or more, a RECORDED Notice of commencement is required.
PERMIT APPLICATION FOR: Reroof
PROPOSED IM PROVEM ENT LOCATION :
Address: 6001 Citrus Avenue
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION I N FORMATIO N :
OWNER/LESSEE:CONTRACTOR:
Name Sussn F. McClure
Address: 6001 Citrus Avenue
City:Ft. Pierce State: FL
Zip Code: 37982 Fax:
Phone No.
Mail:
E-
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: David Packard
Company: Packard Roofing & Waterpoofing, lnc.
Address:2182 NW Reserve Park Trace
City: Port St. Lucie StAtE: FL
Zip Code: 34986 y1y. 772-468-9978
phone No772-468-3723
5-X713;1 ssmith@pac\ardroofing.com
State or County License CCCA17517
SU PPLEM ENTAL CO NSTR UCTIO N LI EN LAW I N FO RMATIO t\I :
DESIGNER/ENGINEER: X Not Applicable
Name:
Address:
City:State:
zip:Phone
MORTGAGE COMPANy: X Not Applicable
Name:
Address:
City:State:
Zip: _Phone
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Phone:
Address:
City: _
Zip: _
BONDING COMPANY: x Not Applicable
Address:
City:
Zip:
--
Phone:
owNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation ., indIIJ
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Countv makes no representation that is granting a permit will authorize the permit holder to build the subiect structurewhich conflicts with anv applica6le Homeown-ei!"nsCotiitio6-rijid,E;iii;;;;-,li.c i.ieiiiiiii'i[.i]riy ,estri.t or prbhibit suchstructure' Please consult with youi Homeowiie;'s As;ili;ii5; ;;dTeile,iJffirii;Hi&';;y i"li?iltiliilJ i,iriilii il.['J'['[ifl '"''
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the workin accordance with the approved plans, the Florida Building Codes anA 5t. Lucie Couniy Amenainenis.
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 tuvice forimprovements to your property. A N,otice of commerrcam;ni m;;i bJi"';il;J iliffiiltjic'Iecords of st.I rrria farrnfrr ani naa+^.l ^^ +r.^ i^L-:+^ L^a^-^ .L^ a:--! :.----- -!:- , r.::i:1",^c::lly^3ll p."_'^t-"-q:t!l:_i"!:'I"-g"l9l9 .he firsrinspeCtion. ir voL-iiiftJr;'ibt.i-" d;;iftioirurtith lend befowtth lender or an re commencing work or recordins vour Noticr nf Cnmrnon.am6hf
Signature of Contractor - or - Owner Builder as applicable
STATE OF FLORIDA
COUN'' OF St. Lucie
Swoln-to (or affirmed) and subscribed before me of X Physical Presence or online Notarizationthisltllday or Febiuarv . ion oi- -
David Packard
Name of person making statement.
Personally Known X OR Produced ldentification
Type of ldentification Produced
(Signature of Notary PuL
Commission No.(Seal)
.xi*3;;., srepHrxre p. s*rH
ii/,'ir:l-qi Notary Public - Srate of Ftorida
1?r*ft$ ,-,iffi :'#,H tf l:i6,,
Bonded through National Notary lssn,
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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