HomeMy WebLinkAboutBuilding Permit Application-All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11 /4/2021
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:
Auaress:'„ilia ° iata DL_VV rVLL JI LIJUe, rL J413aS
Property Tax ID tl 3410-540-0044-000-4 Lot Nc 6
Site Plan Name. Dorothy E Nichols
Block No. 44
Project Name Re -Roof - Nichols
DETAILED DESCRIPTION OF WORK:
RP-Rnof Shingle / Flat
Urlderii3Vnleflt - Watherlock
Ridge Vent -
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 _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _. Roof 2 Pitch
Total Sq. Ft of Construction: 2233 Sq. Ft. of First Floor:
Cost of Construction: $ 14.977 Utilities: x Sewer _Septic Building Height: 15'
OWNER/LESSEE:
CONTRACTOR:
Name Dorothy E Nichols
Name: Robert Donovan
Address209 NE Prima Vista BLVD
Company: Angi Roofing DBA Total Home Roofing
City: _ Port St Lucie State: FL
Zip Code: 349483 Fax:
Phone No. 305-527-0081
E-Mail: --
Address: 5114 W Okeechobee BIVd,Stilte 201
City: West Palm Beach Sta+.e:-EL
zip Code: 33417 Fax:
Phone No 321-452-9223
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Christa(althroofing,Com
State or County License CCC1330489
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If value of HAVC Is $7,Saa or more, a RECORDED Notice of Commencement Is required.
PPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
IGNER/ENGINEER: Not Applicable MORTGAGE COMPANY:_Not Applicable
e: Name:ress:
r
Address:
: State: _ City:State:
Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
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 noyywork or installation has commenced prior to the issuance of a permit.
St.
Is In confliccttawith any applicablelHome Owners Associatio Irules,ll by bylaws or and covenants that mapermit holder to y subject
such
restrict or prohibit
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
ttorne before commencin work or recordin our Notice of Commencement.
Signature of Ow Lessee/Contractor as Agent for Owner
STATE OF FLORA
COUNTY OF
Sworn rn for affir ed) qqd subscribed before me of _JX Physical Presence or Online Notarization
this 1
ruayof_Mar _J2022 by
Robert Donovan
Name of person making statement.
Personally Known X OR Produced Identifica '
_
Type of Identi 'cation Produce
(Sign re of Not Publ'c-gSSJ@te ofFFlorida )
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Commission No. l� V v eal)
CHRISTA-LYN&AUXNSON
MYCOMMISSION8GGEXPIRES:
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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