HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:1i ANNE0 mit tuber:
RECEFILE
IVED
Building Permit Application APR 17 2018
Planning and Development Services ST• hucio County, Pormleting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential VVV
PERMIT APPLICATION FOR: Roof —
PROPOSE D.]MRRO,VEMENT' LOCATION.-
Legal Description: C),,r1. i_ � ! -
Property Tax ID #• L+?, I (1 t)Z^ () I L.Pz` dcl - Lot No. I -� Z
Site Plan Name: N/A Block No. t1'_�
Project Name: N/A
Setbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
DETAILED DESCRIPTION,0F WORK:
eXc S+n S 1�.� nc�l� rck �w,� . r001.
��`�wc�c� �v���, .� vac Cie. Vv� wk��
n'\e � O -1 �1
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.1 r k,
CONSTRCJ.CTLON INFORMATION:
ne
Additional work to a orme under tispermit—c check
OHVAC FI Tank ❑Gas Piping
a
appy:
Shutters
Windows/Doors
Gas
_
0 Electric 0 Plumbing Sprinklers
Generator
Roof Roof pitch
L;J
Total Sq. Ft of Construction: ZI IA
S . Ft. of First Floor: N/A
0Septic
N/A
Cost of Construction: $ r�� n
, or utilities.. Sewer
Building Height:
,
CONTRACTOR
Name V101er
Name: Christopher Collins
Address: 0,Ave-
Company: Collins Roofing Inc.
City:._�ID IP.1" (C� _ State:
`2J `I 7_
Zip Code: Fax: N/A
Phone No. N/A
Address: P.O. Box 12867
City: Ft. Pierce State: FL
Zip Code: 34979 Fax: 772-489-6505
Phone No. 772-201-1352
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
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTALCONSTRUCTION LIEN LAW
INFORIVIATIO;N
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City: Ft. Pierce
State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address: P.O. Box 12867
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.
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 respec
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendm
The following buil • permit a ations are empt from undergoing a full concurre review:
accessory str Gres, swim ' g p ols, fences, w Ils, signs, screen rooms and acce ry uses to i
WARN G TO O o failure to R ord a Notice of Commen ment ma esult
imp r vements r pr erty. A Not' a of Commencement ust be re rd i
be re the fi pecti . If d to obtain financing, onsult wi I
mmenci or i Notice of CommenceVert.
perform the work
mad 'tions,
er non residential use
,you payingtwicef
1p ted a jo '
a rn efo
i
gn tur Owne/Contractor as Agent for Owner
Signatu ntractor icense Holder
STATE OF FLORIDA
COUNTY St 4--r
STATE OF FLORIDA
COUNTY OF
OF G-P-
G'e
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
thisn I �;Lday of 201,�-by
day of, 20_Lf- by
this!
ft I
%
l �►1 ✓ �� �1 key.-
Name of pe-rsonmg statement
rsa m
Name of peon mg statement
Personally Known � OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
S�- 41�"
Produced
&,�L <�
—ne�
(Signs
—
�� 5t'ate sf
(Signature f u-
Commi .
oa"°"�• CATHY J ROBERTS
Y
L$°, p R:�o uie o(g�j�a
�.�"""" CATHYJ OBERTS
Commissio `` %% t{{i;;Stat gI1rlda
• •: omm ss on # FF 221708
°:� My Comm. Expires May 1 C. 20194
'• r a
"P2 Commisslon` FF 221708
;FoFAnrdwithrritinh i ,i ni w ,n �.r. {'.'
:,;,� o��°r`� My Comm. Expires May 10, 2019
Po����
ion o a
y sn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
MANGROVE
VGETATfV
E T R
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17