HomeMy WebLinkAboutPermit Application.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
0
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: 5790 Seminole Rd Fort Pierce, FL 34951
Property Tax ID #: 5790 Seminole Road Lot No.
Site Plan Name: Jason Wright Block No.
Project Name: Jason Wright
DETAILED DESCRIPTION OF WORK:
Remove existing roof system 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 (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 i Roof Pitch
Total Sq. Ft of Construction: 2200 Sq. Ft. of First Floor: 2200
Cost of Construction: $ 13,800.00 Utilities: _ Sewer _ Septic Building Height: 20 ft
OWNERAESSEE:
CONTRACTOR:
NameJason Wright
Name: Dee Keihn
Address: 5790 Seminole Rd
Company: PDKRoofin .Inc
City: Fort Pierce State: FL
Address:1761 SW Biltmore St
Zip Code: 34951 Fax:
City: Port St Lucie State: FL
Phone No. (772) 332-3405 E-
Zip Code: 34984 Fax:
Mail:PDKRoofing.lnc@gmail.com
Phone No (772)528-0113
E-Mail PDKRoofing.inc@,qmail.com
Fill in fee simple Title Holder on next page (if different
State or County License CCC1331408
from the Owner listed above)
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
witWf�,nder or an..attornev before commencing work or recording vour Notice of Commencement.
Signature of Contra tar - or - Owner Builder as applicable
STATE OF FLORIDA
6� I�J COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of NVA*Z6 20tL by
wJDa K.1l,l��
Name of person making statement.
Personally Known . C OR Produced Identification
Type of Identificatio duced
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(5ignatur of to lic- State of Flor
Commiss on No. (S I}
da F ;- ALEXANDERAGUIRRE
2341311
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Rev 10/12/21