HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APIPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date. �� Permit Number
--- i - - By
LDepartmen"t
,� 2018
Building Permit Application
Plann pg and Development Services
Buildi Ig and Code Regulation Division County 1'L
2300 ►rginia Avenue, Fort Pierce FL 34982 r
PhonIle: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PER�','ITAPPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Addre js: 2207 BARBARA AVE FT PIERCE, FL 34982
Legal Qescription: FLEETWOOD ACRES BLK 2 LOT 2 (0.21 AC) (OR 356-1041: 1354-1068)
Prope,' y Tax ID #: 2428-604-0018-000-3
Site P an Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REMLIVE EXISTING MODIFIED ROOF AND INSTALL NEW MODIFIED ROOF
Lot No. 2
Block No. 2
CO STRUCTION INFORMATION:
��,� iIona wor to e e orme under this permit — c ec a apply:
LIJHVAC E] Gas Tank Gas Piping _ Shutters Q Windows/Doors
11 Electric ElPlumbing ❑Sprinklers 0 Generator W1 Roof 2 Roof pitch
Tota Sq. Ft of Construction: 700 S . Ft.
of First Floor:
Cost pf Construction: $ 5400 Utilities: L_I Sewer Septic Building Height: 9'
I
OW.N
ER/LESSEE:
CONTRACTOR:
Adess:
Na iil'
Cit
ZipLode:
Phoji
E-M
Fill �lh
fro I
e JUDY HASELGROVE
Name: ANDREW GRIFFIS
Company: ALL AREA ROOFING
Address: 3921 S US HWY 1
City: FT PIERCE State: FL
Zip Code: 34982 Fax: 772-464-6600
Phone No. 772-464-6800
SAME AS ABOVE
State:
Fax:
a No. 772-465-5934
ail:
fee simple Title Holder on next page (if different
the Owner listed above)
E-Mail: JENNIFER@ALLAREAROOFINGFTP.COM
State or County License: CCC1330649
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
. i• }
IA
y ^Y
DESIG ER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name
Name:
Address:
Address:
City: ��
State:
City: State:
Zip: JI Phone
I
Zip: Phone:
FEE S MPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY: Not Applicable
Nam
'ss:
Name:
Addr
Address:
City:
City:
Zip:
Phone:
I
Zip: Phone:
OWN / CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated'
I certi that no work or installation has commenced prior to the issuance of a permit.
St. Luci County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which i in conflict with any'applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structu e. 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 acco&Ince with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The folllbwing building permit applications are exempt from undergoing a full concurrency review: room additions,
access��y structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARDING TO OWNER: Your failure to Record a Notice of Commencemen may result in your paying twice for
impro, re to yo property. A Notice of Commencement must ;b recorde and posted on the jobsite
befor th ' sit ins ction. If you ten to o ain financing, cons ith len r or an at orney before
col �e I wor or recordin our oti of Commencement
01
n Iture of Owner/ Lessee/Contr ctor Agent for Owner
gnature of Contractor/License d
STA E OF FLORIDA
STATE OF FLORIDA
CO NTY OF S+ Lic1-c.
COUNTY OF S+ I.C,LC,1f,
The rppoing instrument was acknowledged before me
this Po( day of J i �U 20 i� by
The forgoing instrument was acknowledged before me
this � day of , 20 I by
�i
zW I
O rS
y �-2 @.l� l 3 (r_ t _
Name of person aking statement
Produced Identification
Name of person making statement
Personally Known OR Produced Identification
Per onally Known �7 OR
_�
Typ of Identification
Type of Identification
Pro uced
Produced
Notary ublic- State of Florida
ature o )
i cite of Notary Public- State of Florida )
Co
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mission No. ° MY7;O 6SION#GG003939
o�::;R'c FA MASON
Commission No. e * MY CZ ION #GG003939
* ' ' EXPIRES: June 20, 2020
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EXPIRES: June 20, 2020
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