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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/21/22 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:
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Address: 5731 Clydesdale Ln, Port St. Lucie, FL 34987
3309-605-0011.000.4
Property Tax ID #:
Site Plan Name:
Project Name: Roof replacement project (shingles)
Lot No.
Block No.
Remove existing shingle roof down to plywood decking. Re -nail roof decking to updated code requirements. Install self adhered'
underlayment per.code requirements. Install new shingle roof.
New Electrical Meter Second Electrical Meter (Affidavit required)
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 4l12 Pitch
Total Sq. Ft of Construction: 3981 Sq. Ft. of First Floor:
Cost of Construction: $ 22,304 Utilities: _ Sewer _ Septic Building Height: 1 story
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CONTRACTOR
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Name Matthew Herold
Address: 5731 Clydesdale Ln
Name: Cody Rhea
Company: FIXD Roofing LLC
City: Port St Lucie State:FL
Zip Code: 34987-3006 Fax:
Phone No.772-834-7059 E-
Mail:Mherold28@yahoo.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Address: 5870 Mustang Circle
City: Port St Lucie State: FL
Zip Code: 34987 Fax:
Phone N0772-618-3493
E-Mail fixdroofingCgmail.com
State or County LicenseState CCC1332497
It 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.
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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 recordin>; vour Notice of Commencement.
Signature of Contractor - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF Ijj�:�
Sworn Jo (or affirmed and subscribed before me of Physical Presence or Online Notarization
this -)-I day of ✓ -- 20_,Uby
Name o s n ing statement.
P rsonally Known OR Produced Ider�t ficat* n
Ty Ide tifi ion Produced
( ignatur f N ary Public- State of Florida)
Commission No.6 (Seal)
io DAVID MCCREA
B,':.
Q:i Notary Public - State of Florida
:?DO,o Commission # GG 211956
My Comm. Expires Jun 27, 2022
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Rev 10/12/21