HomeMy WebLinkAboutPermit app 45340_0001All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
9�Lro Q19
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:
Property Tax ID #: 1312-500-0095-000-8
Site Plan Name:
Project Name: Re -Roof / Shortz
DETAILED DESCRIPTION OF WORK:
Re-Rnnf Shingle / Tapered Flat
Underlayment - Weatherlock
Ridge Vent - OC Ridge vent
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Lot No.
Block No. 94
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_Electric _Plumbing _Sprinklers _Generator X Roof 4 Pitch
Total Sq. Ft of Construction: 3900 Sq. Ft. of First Floor:
Cost of Construction: $ 20,788 Utilities: x Sewer _ Septic Building Height:15
OWNER/LESSEE:
CONTRACTOR:
Name Florence Shortz
Name: Robert Donovan
Address: 5510 Eagle Dr
CompanyAngi Roofing LLC DBA Total Home Roofing
city: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No. (816) 532-2323
Address: 5114 W Okeechobee Blvd, Suite 701
city: West Palm Beach State: Fl
Zip Code: 33417 Fax:
Phone No 321-452-9223
E-Mail: PSLpermitsAthroofinp.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Christa(d)throofing.com
State or County License CCC1330489
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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 thegermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an 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 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 attornev before commencing work or recording; your Notice of Commencement.
Signature of Ow Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of X Physical Presence or _ Online Notarization
this 1 day of 1`00( 201E by
Robert Donovan
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identifi9ption Produced
REVIEWS
RECEIVED
Public- State of Florida )
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COUNTER TER I REVIEW W I SUPERVISOR REVIEW I PLANS REVIEW I VEGETATION EVI WI S REVIEW LE I MANGROVE