HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL II PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ® �(� S-07
Dat' :y ' d Permit Number: b .
FRF P
Building Permit ApplicatiTRe2tle4ygj!e
AUG202018
ing and Development Services
ng and Code Regulation Division Permitting Department
Virginia Avenue, Fort Pierce FL 34982
e: (772) 462-1553 Fax: (772) 462-1578 Commercial taut r FL
PER
WT APPLICATION FOR: Roof
PRdPOSED
1MPROVEME'NT LOCATION: 4 IN Q,V
5111 Sunset Blvd, Ft. Pierce Fl, 34982 �u
Addr s:
s�, � �f� ail
Legal escription:
INDIAN RIVER ESTATES -UNIT 07- BLK 52 LOT 29
I'
I' Q
PropiifYty Tax ID #: 3402-608-0469-000-4 Lot No. �!
I
Site Plan Name: Block No.
1 Profe It Name: Yates Reroof
Setbi cks Front Back: Right Side: Left Side:
DET,, ILED DESCRIPTION OF WORK:
Re4ve exisiting material down to deck, Renail to code, Install 30# underlayment, Install 5V 26g
CONSTRUCTION INFORMATION:
i.. iona workto e ne orme under this permit —check a apply:
I� HVAC L_J Gas Tank ❑Gas Piping Shutters
�! Electric El Plumbing []Sprinklers Generator
Totalj5q. Ft of Construction: 2227
i
Cost f Construction: $ 10,855
I I
SqFt. of First Floor: _
Utilities: 0 Sewer El Septic
QWindows/Doors
R1Roof Roof pitch
Building Height: 1121
OW
; ER/LESS'EE:
CONTRACTOR:
Naml
Ac I
City:
Zip
Phon'
E-M
Fill in
fromil'
is
Name-
Company: Code d Roofers
Address: 14t
City: State: FL
Zip Code: 34997 Fax:%%,2,2 % T%p3
Phone No. 772-287-2829
ss: V
L
-�ff�� State:FL
de: 34982 Fax:
No.772-464-9614
il:
simple Title Holder on next page ( if different
he Owner listed above)
E-Mail: l `S
State o County Licens . CCC1326574
If valu', of construction is $2500 or more, a RECORDED Notice of Commencement is required.
'SUP,
LEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
ss•
Add''r
City:
Address:
City: State:
State:
III
Zip:
Phone
1
Zip: Phone:
FEE �MPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Add rgss:
City:IT
Address:
City:
Zip: Phone:
Zip: ,III Phone:
II
OWNE / CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certi l � that no work or installation has commenced prior to the issuance of a permit.
St. Luci'll 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
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 accortlance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The foll wing building permit applications are exempt from undergoing a full concurrency review: room additions,
accesso,°' structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WAR ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impro'ements 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
comm'... cing work or recording vour Notice of Commencement.
re of Owner/ Lessee/,eb_nV6ctor as Agent for Owner Sig ature of
STATE OF FLOTfqlliVl
STATE OF FLORIDA
COON TY OF COUNTY OF
The forgoing instrum t was acknowledged before me
this day of / 2018-by
Name of person making statement
Persorl Ily Known OR Produced Identification
Type of Identifica
Produced
(Signalrelof Notary Public- State of FlorVa )
Comm1sion No. C 6C7(S 3 (Seal)
REVI
DATE I'I��
RECEI ',� D
DATE ,',I
COMP �ET
Rev. 8/21,17
RE
The forgoing nstru t was ackn wledgTby
efore me
fthis�dayof T 0
Na ie f per on making statement
Personally Known OR Produced Identification
Type of Identification
Produced
(SignatuIof Notary Public- Stag of I�lo�ida )
Commission No.�i(� 3 v (Seal)
RExi'��7,zoGG9ltSEVIEWOR REVIEW
NIY COPMISSION � Gi(3 - -
MANGROVE
REVIEW