HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �y
Date: (9 17 Permit Number: / / 06
Building Permit Application JUN 2 8 2ol?
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENTLOCATION:
Address: 336 Borraclough St
Legal Description: REPLAT OF PALM GARDENS BLK 1 LOT9 (0.24 AC) (OR 3608-2740)
Property Tax ID #: 3403-802-0009-000-1 Lot No.9
Site Plan Name: Block No. 1
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED,DESCRIPTION'OF WORK:
Remove existing roof covering and install 26 Ga. 5V crimp metal roof covering
Pitch R)1,31
0HVAC IJ Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction: 1,778
Cost of Construction: $ 8000.00
unaertnis permit —cl
Gas Piping
OSprinklers
an apply:
Shutters
FIGenerator
S Ft. of First Floor: _
Utilities:Sewer OSeptic
QWindows/Doors
R] Roof
Building Height:
OWNER/LESSEE.
CONTRACTOR:
NameSavanna Concierge LLC
Name: Larry Neese
Address:1239 Alton RD
City: Miami Beach State:FL
Zip Code: 33139-3826 Fax:
Phone No.
E-Mail:
company: Larry Neese Roofing, LLC
Address: 488 S. Market Ave.
city: Fort Pierce State: FL
Zip Code: 349824 Fax: 772-361-6581
Phone No. 772-361-6580
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: Iarry(d-)LNroof. corn
State or County License: FL CCC1330608
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
N
SUPPLEMENTAL CONSTRUCTION:LIEN LAW INFORMATTON
Designer/Architect/Engineer: ❑ Not Applicable
Name
Mailing Address
Citv
zip Phone
Fee Simple Title Holder's Name:
Name
Mailing Address
Citv
zip Phone
_ State
❑ Not Applicable
State
Mortgage Company:
Name
Mailing Address
City
zip Phone
Bonding Company:
Name
Mailing Address
Citv
zip Phone
❑ Not Applicable
State
❑ Not Applicable
State
Notice to Owner: There are some properties that may have deed restrictions recorded upon them. These
restrictions may limit or prohibit the work applied for in your building permit. It may be to your
advantage to check and see if your property is encumbered by any restrictions.
Owner/Contractor Affidavit: Application is hereby made to obtain a permit to do the work and installations as
indicated. I certify that no work or installation has commenced prior to the issuance of a permit.
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 2010 Florida Building Code and Martin County Amendments.
Plan revisions on all structures exempted by code from architect/engineer design may be done by permit holder.
Warning to Owner: Your failure to record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the job site before
the first inspection. If you intend to obtain financing, consult with your lender or an attorney before
commencing work or recording your Notice of Commencement.
I certify that all the foregoing information is accurate and that all work will be done in compliance with'all
applicable laws regulating construction and zoning.
Si afore of O /Ag t/Lessee
-------------
STATE OF FLORIDA
COUNTY OF MARTIN
The foregoing instrument was acknowledged before me
this day of , 20_ by
(Name of Person Acknowledging)
(Signature of Notary Public — State of Florida)
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known OR Produced Identification
Type of Identification Produced
(FBC 2010)
•e of Contr for icense Holder
STATE OF FLORIDA
COUNTY OF MARTIN
The foregoing instrument was acknowledged before me
this at�, day of Tu a ,-- 20 j,_1 by
tn't,
(Name of Person
(Signature of Notary Public — State of Florida)
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known 41-1 OR Produced Identification
Type of Identification Produced
T:\BLDUdg_yorms\New Applications\Applications\Building Permit Application.Docx Rev. 3/16/12
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