HomeMy WebLinkAboutBuilding Permit ApplicationAII APPLICABLE INFO MUST BE COMPTETED FOR APPLICATION TO BE ACCEPTED
Date:Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2j00 Virginio Avenue, Fort Pierce FL j4982
Phone: 1772) 462-t5s3 Fax: (772\ 462-tS7B
Commercial Residential X
CBDG Funding
PERMIT APPLICATION FOR: Reroof
PROPOSED IMPROVEM ENT LOCATION :
Address: 6001 Citrus Avenue
PropertyTaxfD#,@ t-ot wo. 12
Block No. 1Site Plan Name:
Project Name:
Remove le roof and renail MTS Plus self ad modified bitumen
underlayment.lnstall IKO Cambridge dimensional
New Electrical Meter_second Electrical Meter (Affidavit required)
CONSTRUCTION IN FORMATION :
Additional work to be performed under this permh - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping Sh utters _ WindowslDoors
_ Electric _ Plumbing _ Sprinklers _ Generatgr
Sq. Ft. of First Floor:
X noof 5112 pi1st1
Totat sq. Ft of construction, I 0 0O
Cost of Construction: t 5 Utilities: _ Sewer _ Septic Building Height:
lf value of construction is 2500 or more, a RECOBDED Noti€e of Commencement is required,
DETAILED DESCRIPTION OF WORK:
OWNER/LESSEE:CONTRACTOR:
Name Susor F. McClure
Address: 6001 Citrus Avenue
City: Ft' Pierce State: FL
ZiP Code: 34982 Fax:
Phone No.E-
Fill in fee simple Title Holder on next page {if different
from the Owner listed above)
gr13ms; David Packard
Company: Packard Roofing & Waterpoofi.ng, lnc.
Address:2182 NW Reserve Park Trace
City: Port St. Lucie State: FL
Zip code: 34986 sr*. 772-468-9978
phone No 772-468-3723
g-14611 ssmith@packardroofi ng.com
State or County License CCCA17S17
lf value of HAVC is 57,500 or more, a REC0RDED Notice of commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _r/ Not Applicable
Name:
Address:
City:State:
zip:Phone
MORTGAGE COMPANY: " Not Applicable
Name:
Address:
City:State:
zip.,Phone:
FEE SIMPIE TITLE HOLDER: V ruot Applicable
Name:
Address:
City:
zip:Phone:
BONDING COMPANY: _ Ytlot Applicable
Name:
Phone:
OWNER/ CONTR.ACTOR 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 Countv makes no reoresentation that is erantins a oermit will authorize the oermit holder to build the subiect structure
which conflicts with anv aoolicable Homeowners-Associa-tioh rules. bvlaws or and coVenants that mav restrict or pr6hibit such
structure. Please consu'lt with your Homeowners Association and ieview your deed for any restrictions which may apply.
ln 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 5t. Lucie County Amendments.
The following buitding 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.
Luiie County and fosted on ttre jobsite before the first inspection. lf you intend to obtain financing, consult
with lender or an before com ing work or record Notice of Commencement.
Signature of Contractor - or - Owner Builder as applicable
STATE OF FLORIDA
couNTY oF 5t Lo.-j<
y'pnvrir^lPresence or
-
Online Notarization
Name of person making statement.
./
Personally Known t/ OR Produced ldentification
{signature of Notary Public- State of Florida)
Commission No.(Seal)
..li*&;;. STEPHANIE P. SltlTH
:-i? ..*I1 Notary Public - State of Florida,?ffii$ -,','ffiI'#,lJUf l: il,,
BonCed through ttational ilotary Assn.
ZONING
REVIEW
VEGETATION
REVIEW
DATE
COMPLETED
Address:
Citv:
zip:
Sworn to {or affirmed) and subscribed before me of
thisl8 davof lVlA/t-l-:. ,zoL}bv