HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ____________________ Permit Number: _____________________
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial __________ Residential ___________
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding _________
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: __________________________________________________________________________________________
Property Tax ID #: _________________________________________________________________ Lot No.__________
Site Plan Name: __________________________________________________________________ Block No. _______
Project Name: ______________________________________________________________________________________
DETAILED DESCRIPTION OF WORK:
_________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
New Electrical Meter __________ Second Electrical Meter_______________ (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit ʹ check all that apply:
__Mechanical __ Gas Tank __ Gas Piping __ Shutters ___ Windows/Doors ___ Pond
__ Electric __ Plumbing __ Sprinklers __ Generator ___ Roof __________ Pitch
Total Sq. Ft of Construction: ___________________ Sq. Ft. of First Floor: _________________________
Cost of Construction: $ _____________________ Utilities: __ Sewer __ Septic Building Height: __________
OWNER/LESSEE: CONTRACTOR:
Name__________________________________________
Address: ________________________________________
City: _________________________________ State: ___
Zip Code: ______________ Fax: ____________________
Phone No.______________________________________ E-
Mail:________________________________________
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: ________________________________________
Company: _____________________________________
Address: _______________________________________
City: ______________________________ State: ____
Zip Code: ________________ Fax: __________________
Phone No______________________________________
E-Mail_________________________________________
State or County License___________________________
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.
5835 Whipoorwill Lane
ReRoof
3211-811-0015-000-5
Olena Jernigan
6
Shingle to Shingle ReRoof including Flat Roof
B
x
x
6/12 & 1/12
10’17,888
5835 Whipoorwill Lane
Olena Jernigan
PSL
Charles K Pittman
Storm Team Construction
4050 S US HWY 1
Jupiter FL
33477
740-274-3004
permits@stormteamusa.com
CCC1332349
772-201-9507
34987
FL
2.28.22
Shingle NOA: 21-1215.02 RV NOA: 20-0723.40 Underlayment NOA 20-0723.36 Flat Roof NOA: FL16709.R9
February28th 22
Palm Beach