HomeMy WebLinkAboutFL-1383- Margaret Fulcher Permit App - Rolled Roof Permit App.pdfAll 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 – 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.
ReRoof -
Re-roof with full tear-off and replacement of asphalt rolled roofing on low sloped roof section
X
Re-roof - Rolled Roofing
The Exterior Company
Darren Baker
311 Harrisburg Avenue
Lancaster PA
17603 855-766-3274
855-766-3264
Info@TECRoofs.com
CCC1331906 32786
FL
RE-ROOF
03/21/2022
✔
6010 Whipoorwill Lane, Fort Pierce, FL 34987
3211-811-0018-000-6
HIDDEN ACRES BLK C LOT 3 (2.90 AC)
3
FL-1383 - ROLLED
C
882
20,780.09 (TOTAL)
Margaret Fulcher
6010 Whipoorwill Lane
Fort Pierce
34987
(772) 359-1831
pcjb19733@gmail.com
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ___ Not Applicable
Name: _____________________________________
Address: __________________________________
City: __________________________ State: _____
Zip: ___________ Phone______________________
MORTGAGE COMPANY: ___ Not Applicable
Name: ____________________________________
Address: ___________________________________
City: ____________________________State: _____
Zip: __________ Phone: ______________________
FEE SIMPLE TITLE HOLDER: ___ Not Applicable
Name: _____________________________________
Address: ___________________________________
City: _______________________________________
Zip: ___________ Phone: ______________________
BONDING COMPANY: ___Not Applicable
Name: ____________________________________
Address: ______________________________________
City: __________________________________________
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 structur e
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.
___________________________________________
Signature of Contractor - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF_________________________________
Sworn to (or affirmed) and subscribed before me of ____ Physical Presence or _____ Online Notarization
this ____ day of _________________, 20___ by
Name of person making statement.
Personally Known _______ OR Produced Identification ______
Type of Identification Produced__________________________
(Signature of Notary Public- State of Florida)
Commission No. ______________ (Seal)
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 10/12/21
X
Darren Baker
X
1396327
======= PENNSYLVANIA
YORK
21 March 22