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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED p�
Date: 1 SCANNE .I Permit Number: V
8Y
St Lurie Cou ty RECEIVED
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
PERMIT APPLICATION FOR: Roof
FEB 2 0 2018
ST. Lucie County, Psrmitting
Residential Yes
[-PROPOSED IMPROVEMENT LOCATION: 'I
Address:
Legal Description:
Property Tax ID #: 4509
09
Site Plan Name: N/a
Project Name: N/a
Setbacks Front N/a Back: N/a
DETAILED DESCRIPTION OF WORK:
t
I
�- �My
Right Side: N/a
Left Side: N/a
Lot No.
Block No.
We will tear off a existing roofing down to the plywood, Re -nail the deck to the current code and Re-roof.Wsw�
�-� 0� Ong. �/. &
i
CONSTRUCTION INFORMATION:
Additional work to be nertormed under t is;permit— check 811 apply:
[_1HVAC Lj_I Gas Tank EJGas Piping _ Shutters a Windows/Doors
DElectric 0 Plumbing i Sprinklers ElGenerator F] Roof 0(;LTi 4cV\
Total Sq. Ft of Construction: M 44 S . Ft. of First Floor: N/a *12-
I
Cost of Construction: $ J 19 �-0• I Utilities: _ Sewer 0 Septic Building Height: N/a
i
OWNER/LESSEE:
CONTRACTOR:
Name
i
Name: Christopher Collins
Address: Ulf LV\
City: State:
Zip Code: Fax: N/a i
Phone No. N/a
Company: Collins Roofing Inc
Address: PO Box 12867
City: Fort Pierce State: FL
Zip Code: 34979 Fax: 772-489-6505
Phone No. 772-201-1352 or 772940-8607
E-Mail: Collinsroofinginc@gmail.com
E-Mail: N/a
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: CCC-058011
IIf value of construction is $2500 or more, a RECORDED Notice of Commencement is required. II
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: d_ Not Applicable MORTGAGE COMPANY: d_ Not Applicable
Name: Name:
Address: I Address:
City: State:I City: State:
Zip: Phone: Zip: Phone:
.FEE SIMPLE TITLE HOLDER: d_ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
Citv:
Zip: Phone:
Not Applicable
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 Cou endments.
The following b er p ica " ns are exempt from undergoing a full ncurrency ew: roo dditions,
accessory ctures, s ming pools, nces, walls, signs, s, screen rooms d accesso se to another n n-residential use
WAR G TO N R: Your fail a to Record a Notice of C mence nt a result in yo r paying twice for
imp vem a r pr erty A Notice of Commence ent mu bWtdc rded a p sted on the jobsite
b ore t f' s e,If y u intend to obtain fina cing, con end attorney before
mm r r rdi a vour Notice of'Com ncemen .
STATE OF FLORID/ j'
COUNTY OF �-
The for oing instru t was acknowledge efore me
this day of 20 by
:r.0rr:�
STATE OF FLORIIR k��i
COUNTY OF l
The forgoing instrumgont was acknowledged before me
this zoi day of f' 120 — by
(Name of person acknowledging) (Name
vs Vkk9[0N imopeN 4�41 P PeoEtIoAda
LZoZ'8l oap SgJ dx3 wwo0 AA#uopslwwo0�o o a e1S --oilgndtisloN(Signa re of Notary Public- State of Florida) (Signa re of Sta
Personally Known OR Produced Identi [cation I {/ Personally Known OR Prod ced Identification
Type of Identification Produced I Type of Identification Produced Lt ,2i1�,� n33'3D
Commission No. (S�,gIR E N S. I N I E L S E N C mission No. (Seal)
=�V Commission # FF 115637
=tr a My Commissiion Expire
' ii June
Revised 07/15/2014 1
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