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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: I U©U - c /_�pU
Building Permit Application PEW
ning and Development Services St. LUC(aCcun
ling and Code Regulation Division
) Virginia Avenue, Fort Pierce FL 34982 X
ne: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof
ROPOSED IMPROVEMENT LOCATION:
Address: 5811 Shannon Drive Fort Pierce, Fl. 34951
Description:
Lakewood Park Unit 11 Blk 140 Lot 19
ierty Tax ID #: 1301-613-0103-000-1
Plan Name:
act Name: John Baumker
Jacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Lot No.
Block No.
off existing slope and flat roof. Renail sheathing to code. Dry in slope roof with Tribult Sand SA FL16048-R6 install
ns Corning Tru Definition Shinlges FL16074-R13. On Flat roof install 1/4" per ft. tapered insulation and Polyglass
;toflex SA V as base and Elastoflex SA P as cap.
QONSTRUCTION INFORMATION:
—aditiona wor to jeer orme under t is permit - c ec a app y:
11HVAC L__I Gas Tank Gas Piping Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof 3/12 Roof pitch
T tal Sq. Ft of Construction: 2200 S Ft. of First Floor:
C st of Construction: $ 13,300.00 Utilities:In Sewer 0 Septic Building Height:
WNER/LESSEE:
CONTRACTOR:
N
Address:
Ci
Zip
Pf�one
E
Fi
fir
mme John Baumker
Name: Christopher A. Long
Company: The Roof Authority, Inc.
5811 Shannon Drive
ty: Fort Pierce State: FL
Code: 34951 Fax:
No. 772-240-5506
Address: 6771 N. old Dixie Hwy.
City: Fort Pierce State: Fl.
Zip Code: 34951 Fax: 772-468-2247
Phone No. 772-468-7870
Mail:
I in fee simple Title Holder on next page ( if different
m the Owner listed above)
E-Mail: tral993pgmail.com /joann.tra@gmail.com
State or County License: CCC056933
If �alue of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
address:
City:
Zip: Phone:
III
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I Icertify that no work or installation has commenced prior to the issuance of a permit.
S l Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
ich is in,conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
stfucture. 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.
Tie following building permit applications are exempt from undergoing a full concurrency review: room additions,
a Icessory 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
i provements 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
ci mmencing work or recording your Notice of Commencements i1
J
s Agent for Owner I Signkture of Contractor/License Holder
ATE OF FLORIDA STATEDF FLORIDA
)LINTY OF St. Lucie COUNTY OF St. Lucie
forgoing instru ent was acknowledged before me
yday of /�v 20�by
✓6 kA) 1141)U4kC4_
Name of person making statement
ersonally Known OR Produced Identification
ype of Identification
roduced 7�-L 'j C_
n
iature o� Notary Public-
r,State of Florida )
�)"�1KL �OtPR I) Timothy W. Sutton
mission No. C? C7
NOTARY PUBLIC
• STATE OF FLORI
EWS I COUO TJPERVIS
ER REEVIEW INING REVIEW
TE
'EIVED
MPLETED
8/2/17
The for ing instrument was acknowledged before me
this ay of :o S7 20teby
Christopher A. Long
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
G QthyW, Sutton
Commission No. C� u j(L�tARY�s (SNOTARY PUBLIC
A
�� � STATE OF FLORIDA
PLANS I VEGETATION I SEA TURTLE ---MANGRO
REVIEW REVIEW REVIEW REVIEW