HomeMy WebLinkAboutBUILDING PERMIT APPLICATION1
ALL APPLICABLE INFO MUST BE COMPLETED FOR
Date: � 41* rq
Building
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
TO BE ACCEPTED
. Permit Number:
it Applicatior
mercial
RECEIVED
APR 3 0 2018
ST. Lucie County, Permitting J
ci rix-ni in I-,c—
PERMIT APPLICATION FOR: Roof- C$ Jrh r
PROPOSED IMPROVEMENT LOCATION:.',
Address: 7354 Pine Creek Way
Legal Description. 22 36 39 That part of Sec 22 MPDIN OR 52-618 and Known as Pine Creek Townhomes Phase IIB
Bldg 8 Unit 24, 7354 Pine Creek Way
Property Tax ID M. 3322-233-0024-000-8 I Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right ide: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove wood shakes on main house- , renail plywood, apply 30# felt, 1444 / $�� &<-1'� 30�
y".f., 64 . install heavy pressure treated wo , d shakes. Flat roof - Apply Polyglass SAV base sheet
and SAP cap sheet self adhering.
CONSTRUCTION INFORMATION: J
Additional work to je De orme under this permit = c ec a apply:
L �HVAC J Gas Tank ❑Gas Pipi g _ Shutters a Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof �� Roof pitch
Total Sq. Ft of Construction:- o � 0 S . Ft. of First Floor:
Cost of Construction: 4 , , v Utilities: Sewer F]Septic Building Height: 0
OWNERAESSEE:. `'
CONTRACTOR:.
NameAdrian Greenberg
Name: David Packard
Address: 7354 Pine Creek Way
Company: Packard Roofing & Waterproofing, Inc.
City: Port St. Lucie State:�1L
Address: 2182 NW Reserve Park Trace
Zip Code: 34986 Fax:
Phone No.631-252-0612 "' :
City: Port St. Lucie State: FL
Zip Code: 34986 Fax: 772468-9978
E-Mail:
Phone No. 772-468-3723
E-Mail:.ssmith@packardroofing.com
Fill in fee simple Title Holder on next page (if differ nt
from the Owner listed above)
State or County License. CCCA17517
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL -CONSTRUCTION LIEN; LAW
INFORMATION:,
DESIGNER/ENGINEER: Not ApplicablE;
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: Not Applicable
Name:
Address:
I
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicabl6
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: XNot Applicable
Name:
Address:
city:
I
Zip: Phone:
I
OWNER/ CONTRACTOR AFFIDVIT: Application is her Iby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior t6 the issuance of a permit.
St. Lucie County makes no representation that is granting a �ermit 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 Associatioh 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 odes and St. Lucie County Amendments.
The following building permit applications are exempt from ndergoing 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 inancing, consult with lender or an attorney before
commencing work or recording; vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent
STATE OF FLORIDA
COUNTY OF '5+. LAx,!-,0,
The for mg instrument was acknowledged before me
this LlLnay of .At I 20 1 Cby
Name of persoq making statement
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
(Signature of N
, C) _Q _QD
Signature of Contractor/License older
STATE OF FLORIDA
COUNTY OF JJ L.gti
The for Bing instrument was acknowledged before me
this V day of 20_X by
ycwow &Ax cry
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced
1
11��.l.tJL%�• �
(Signature of Noj&gL�bll - State of Florida )
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Commission No_ = ►� .=
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Commission No.
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Rev. 8/2/17