HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED F03001�I N TO BE ACCEPTED
Date: ra,I aaj, 13Y Permit Number: �-4�CD
_ St Lu ip C00111 r�
RECEIVED
Building Permit Application JUN 2 2 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie Caufityj NrnilMnQ
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof — }'`
El -
PROPOSED IMPROVEMENT LOCATION:
Address: 9699 Fairwood Ct.
Legal Description: Fairway Landings Parcel 9 Lot 10
Property Tax ID #: 3322-500-0014-000-4
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Lot No.10
Block No.
Remove tile, re -nail plywood and apply 30# felt. Apply TU Max self adhering underlayment and install
new concrete tile using two galvanized screws per tile. Hip and ridge to be installed with mortar.
Additional work to be ertormed under this permit — check all apply:
DHVAC Ei Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
0 Electric 0 Plumbing Sprinklers [iGenerator Roof 6� 2 ] Roof pitch
Total Sq. Ft of Construction: 5400 S Ft. of First Floor:
Cost of Construction: $ 39,000.00 Utilities:i Sewer Septic Building Height: 1
OWNER/LESSEE:
CONTRACTOR:
Name William Richards
Name: David Packard
Address: 9699 Fairwood Ct.
Company: Packard Roofing & Waterproofing, Inc.
City: Port St. Lucie State:FL
Address: 2182 NW Reserrve Park Trace
Zip Code: 34986 Fax:
City: Port St. Lucie State: FL
Phone No.585-233-9557
Zip Code: 34986 Fax: 772-468-9978
E-Mail:
Phone No. 772-468-3723
Fill in fee simple Title Holder on next page (if different
E-Mail: ssmith@packardroofing.com
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 LAWJNFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address: 9699 Fai-.,,d a.
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: _ of Applicable
Name: {
Name:
Address: '
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.
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 with lender or an attorney before
commencingiwork or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License o er
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF,g .Wcle-
COUNTY OF SE twae
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this at Stay of 60%&¢ 20ig' by
this At 91- day of 20ff by
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Name of person making statement
Name of person making statement
Personally Known ✓ OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signat ru Public;t o &f Florida)
(Signatur
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�q% E SMITH"'SyP
P STEPHANI P,
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STEPHANIE P, SMITH
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•� NotaryPubllc-State ofFll-k-al
c -State of Florida
• ` Commission # GG 139524
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MyComm. Expires Sep 2, 2o21
, • .mmiss on # GG 13952d
;� My Comm. Expires Sep 2, 2021
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Bonded through National NotaryAssn.
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Rev. 8/2/17