HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/17/17 Permit Number:
Building Permit Application
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 IMPROVEMENT LOCATION:
Address: S O � g 9
Legal Description: INDIAN RIVER STATES -UNIT 09- BLK 80 LOT 30 AND NWLY 20 FT OF LOT 31 (MAP 34/12S) (OR 3300-2923)
Property Tax ID #: 3402-610-0321-000-2
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
TEAR OFF EXISTING SHINGLE ROOF AND INSTALL NEW rvkgd 6[ &c3f
Lot No. 30
Block No. 80
CONSTRUCTION INFORMATION:
Additional workto e e orme under this permit— check a apply:
�HVAC Gas Tank Gas Piping _ Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator W1 Roof 1.5/12 Roof pitch
Total Sq. Ft of Construction: 450
Cost of Construction: $ 4025
S Ft. of First Floor: _
Utilities: Sewer Septic
Building Height: 1 STORY
OWNER/LESSEE:
CONTRACTOR:
Name )erv'�NS 1�-echQ- le .
Name: Gil S S
Address: 6 --1 Ek_Q2=Uc
Company: ALL AREA ROOFING
Address: 39 a'I 5, L ks
City: `"i i c rc-e_ State: FL
Zip Code: 34982 Fax: 772-464-6600
Phone No. 772-464-6800
E-Mail: JENNIFER@ALLAREAROOFING.COM
City: 'i�t State: FL
Zip Code: 34982 Fax:
Phone No. 772-341-8818
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: CCC1326177
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applica
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:_
Address:
City:_
Zip:
Pho
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 is in conflict with any applicable Home Owners Association rules, bylaws or and 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult w'th lender or an attorney before
commencing work or recording vour Notice of Commencement. _
Signature of Contractor/License Holder
Signs ure of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OF STLUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 17 day of AUGUST 20_L2 by
this » day of AUGUST 20,1 by
CHARLES RICHARDS
CHARLES RICHARDS
Name of person making statement
Name of person making statement
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public t e of Flori%� MASON
( nature of Notary ublic-State of FI ��ia )
Commission No. ,r * MYCO IS�1ON#G0003939
a aQ :9une20,2020
4610' " FAITH MASON
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Commission No. s Sei
� EXPIRES: June20,202
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17