HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,_
late: 9-4
- j Permit Number: 1 ��
BY
. LI�ItD,,CnP�"ti RECEIVED
Building Permit Application SEP 0 4 z018
ing and Development Services
ng and Code Regulation Division ST. Lucie County, e'rmitting
Virginia Avenue, Fort Pierce FL 34982
ie: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION: �
I Description:
Pr perty Tax ID #: I �U 1 - oco — 0 W()- o � 2 Lot No. 1 �
Sile Plan Name: N/A Block No.
Pr ject Name: N/A
S Itbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
�fAILED DESCRIPTION OF WORK:
W kkl A OJP� 5W l e_ r001pt
l n5k Ck. v\.erori V vYleq
C NSTRUCT ON INFORMATION: _
itiona work to be erformed under this permit —check all apply:
1HVAC E]GasTank ❑Gas Piping
7 Electric ❑ Plumbing Sprinklers
I Sq. Ft of Construction: _1�
of Construction: $ lQ xCl
_ Shutters El-Windows/Do rs
❑ Generator El Roof _ Roof pitch
S Ft. of First Floor: NIA
Utilities:Cn Sewer j Septic
Building Height: NIA
OWNER/LESSEE:
CONTRACTOR; ..
N
'me Muftr 1f
Name: Christopher Collins
dress:
f? Q
pan 9 Inc.
-company: Collins Roofing
A
0. State:
Ci
Address: P•O.'Box 12867
Zi
ly:
p Code: Fax: N/A
City: Ft. Pierce State: FL
Ph
No. N/A
Zip Code: 34979 Fax: 772-489-6505
E
lone
Mail: N/A
Phone No. 772-201-1352
fee simple Title Holder on next page ( if different
E-Mail: collinsroofinginc@gmail.com
Zin
Im the Owner listed above)
State or County License: CCC-058011
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
I,ity: State:
City: Ft. Pierce State:
7i p: Phone
Zip: Phone:
,,EE SIMPLE TITLEHOLDER: IrNot Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address: P.O. Box 12867
Address:
I'ity:
City:
Zip: Phone:
Zip: Phone:
0 . NER/ 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
w V'ch 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 tteapproved plans, the Florida Building Codes and St. Lucie County Amendments.
swing tending per it ions are exempt from undergoing a full c rrenc
ry s,St`uctures, swjmtning pools,)fences, walls, signs, screen rooms apdaccessory u
999nomm
: Your failu a to Record a Notice of Co enprop y. A Notice of Commence nt mtio yo intend to obtain financ' g, con ordin vour Notice of Comme ement.
eview: room additions,
o non-residential use
result in yo r paying twice for
led an p sted on the jobsite
der an ttorney before
ATE OF FLORIDA STATE OF FLORIDA
)LINTY OF .'+- LQ <-t'e COUNTY OF 9+
forgoing instrument was acknowledged before me
day of 9-cp-I- , 20 4—by
r
Name of person Making statement
rsonally Known OR Produced Identification
pe of Identification
The for oing instrument was acknowledged before me
this day of 20 I y
Name of person king statement
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
(signature
19 �
o o
_
(Signature
otT
Ruilit ids}
rP�a�,, a e o^ �i BERTS
C
No
: ,Notary Publig State of Florida
Commission
No.
,�""v ., CATHY J ROBERTS
,�' `B"'
/F "� Notary PubligqS of Florida
l221708
mission
• -
ammissldr� JaPr 221708
'4'
Commisslo�i
My Comm. Explres May 1C, 2019 +
i?
_
�'/��OFP40�QP;
s� p�,. My Comm. Expires May 10, 2019
Bonded through National Notary Assn, t;
,��
Banded through National Notary Assn.
EVIEWS
FRONT v
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
BATE
RECEIVED
DATE
COMPLETED
te�18/2/17