HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
4v-
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
PERMIT APPLICATION FOR: Re -Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 200 Jeffrey Ln Fort Pierce, FL 34982
Property Tax ID ##: 2434-803-0007-000-3
Site Plan Name: Celina Flores
Project Name: Celina Flores
DETAILED DESCRIPTION OF WORK:
Residential X
Remove existing roof and replace with new Asphalt Shingle Roof system
Owens Corning Shingles(FL10674-R16), Omni Roll Vent(FL2847-R15), Tri-built Sand (FL2569-R23)
Lot No.
Block No.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this hermit -check all that apply:
—Mechanical — Gas Tank — Gas Piping —Shutters _ Windows/Doors _ Pond
Electric — Plumbing — Sprinklers — Generator , Roof Pitch
Total Sq. Ft of Construction: 2800 Sq. Ft. of First Floor: 2800
Cost of Construction: $ 14,950.00 Utilities: Sewer Septic Buildin 1i i' ht 15ft
— g eg
OWNER/LESSEE:
CONTRACTOR:
Name Col i nA F1 a rl-5
Name: Dee Keihn
Address: 2.00 3e_ f JAL Lw%
Company: PDKRoofing.lnc
City: �o ��- PIQ FL
State:
Address: 1761 SW Biltmore Street
Zip Code: Yk01$ 2_ Fax:
_
City: Port Saint Lucie FL
State:
Phone No. (772)528-0113
Zip Code: 34984 Fax:
E-Mail: PDKRoofing.lnc@gmail.com
Phone No (772)528-0113
Fill in fee simple Title Holder on next page ( if different E-Mail PDKRoofing.lnc@gmail.com
from the Owner listed above) State or County License CCC1331408
If value of construction is 2snn nr mnra n oCrnonrn ru
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: r 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 is in contlict with any applicable Home Owners Association rules, bylaws or and covenants that may restrictorrppr prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
pI
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 attor before commencin work o r ordin our Not of Commencement.
of OwterLessee/Contractor as Agent for Owner signature of Cottractor/License Holder
STATE OF FLORI A
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
✓ Physical Presence or Online Notarization
this day of /SIG k 2020 by
Name of person making statement.
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida }
Commission No. 9 (Sea%otary Public state
Adam B Chaom
Ex 11a12I
REVIEWS FRONT Z
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
STATE OF FLORI A
COUNTY OF Lv
Sworn to (or affirmed) and subscribed before me of
✓Physical Presence or Online Notarization
this day of /t'lcrci, 7 - J 2020 by
Name of person making/statement.
Personally Known ✓ OR Produced identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
r3s 39 ealNAd�......
on No. �Public
t
Adam BChapr
My Commission
Exp, 11a/2026
REVIEW I VEGETATION I S REVIEW
I 'RENEW