HomeMy WebLinkAboutApplication-UPDAETD WITH PITCHAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
4� LUC E a"OL,
0v o 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:
Address: 200 Jeffrey Ln Fort Pierce, FL 34982
Property Tax ID #: 2434-803-000.7-000-3 Lot No.
Site Plan Name: Celina Flores Block No.
Project Name: Celina Flores
DETAILED DESCRIPTION OF WORK:
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)
New Electrical Meter Second Electrical Meter
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 s/f 'Z. Pitch
Total Sq. Ft of Construction: 2800 Sq. Ft. of First Floor: 2800
Cost of Construction: $ 14,950.00 Utilities: —Sewer _ Septic Building Height: 15ft
OWNER/LESSEE:
CONTRACTOR:
Name Ce1 I nA Flores
Name: pee Keihn
Address: Z60 3e_i4rra Li
City: Iro 0+ C i arCe V'b State: _
Company: PDKRoofing.lnc
Address: 1761 SW Biltmore Street
Zip Code: 31-0182- Fax:
City: Port Saint Lucie State: FL
Phone No. (772)528-0113
E-Mail: PDKRoofing.lnc@gmail.com
Zip Code: 34984 Fax:
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
iT value oT construction is LSuu or more, a RMURDED 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
Name:
Address:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
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.
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 conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of 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
y(ith lender or an attorney before commencing work o,►'r-ecording your NotirCof Commencement.
2�d-
ignature of Ow&r Lessee/Contractor as Agent for Owner
Signature of Co tractor/License Holder
STATE OF FLORA
Luc,t
STATE OF FLORIDA
COUNTY OF S+ Lv
COUNTY OF 3L
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
✓ Physical Presence or Online Notarization
✓Physical Presence or Online Notarization
this —dayofPlGrr_ik ]a'` 2020 by
this day of A-L,%A�" 2020 by
k_c*�r1
Name of person making statement.
Name of person making statement.
Personally Known f✓ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced /f
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. Sea%ojary public State
No. Zl3s a J UealNotary Public Star
f
Adam B Chapman
My Commission
Adam B Chap
7Ign,ion
My Commission
EX . 1/4/2026
Exp. 1W2o26
REVIEWS
FRONT
Z
VEGETATION
SEA L
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20