HomeMy WebLinkAbout1a- Building Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services X
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: Re-Roofing residential home
PROPOSED IMPROVEMENT LOCATION:
Address: 2930 Nicholas Road, Fort Pierce, FL 34982
Property Tax ID#: 2421-334-0001-050-7 Sec/Town/Range: 21/35S/40E Lot No.
Site Plan Name: Block No.
Project Name: Burnette Residence Re-roof
DETAILED DESCRIPTION OF WORK: 1
R move existing roof, re-nail plywood, install self adhered underlayment, galvanized metals and Owens Corning shingles
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 X Roof Pitch
Total Sq. Ft of Construction: _2,851 sf Sq. Ft. of First Floor:
Cost of Construction: $ 14,700.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Christelle Burnette Name: Christopher A. Long
Address: 2930 Nicholas Road Company: The Roof Authority, Inc.
City: Fort Pierce State: FL Address:6771 North Old Dixie Highway
Zip Code: 32982 Fax: City: Fort Pierce State:
Phone No. 772-200-9296 E- Zip Code: 34946 Fax: -468-224T
Mail: Phone No772-468-7870
Fill in fee simple Title Holder on next page (if different E-Mail tra1993agmail.com
from the Owner listed above) State or County License CC C056933
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:.
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: 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 conflicts with any applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 before commencing work or recording your Notice of Commencement.
p Christopher A. Long
Signature of tr for-or-Owner Builder as applicable
STATE OF FL DA
COUNTY OF St. Lucie
Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization
this_8l11 day of March 20 22by Christopher A. Long
Christopher A. Long
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification Produced
Timadw W. Sutton
(Signature of N. tary Public-State of Florida)
Commission No. GG185982 (Seal) t 1'4
Timothy W Sutton
NOTARY PUBLIC
aq STATE OF FLORIDA
=Comm#GG185982
" Fxpires 3/20/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 1013 72r