HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
ANNF_ Permit Number:
St Lucie County RECEIVED
Building Permit Application SEP 112018
Plan {ng and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Pho I : (772).462-1553 Fax: (772) 462-1578 Commercial
Permitting Department
St. Lucie County
Residential X
PERMIT APPLICATION FOR: Roof
;PRO OSED IMPROVEME;NT.LOCATION:.
AddreslIs: 5605 EASTWOOD DR -Fort Pierce FI
Legal Dlescription: LAKEWOOD PARK -UNIT 11- BILK 154 LOT 6 (MAP 13/12N) (OR 553-1852).
Proper�tyTax ID #: 130-1-613-0394-000-7. Lot. No.
Site PI In Name: Block No.
Projec Name:
Setba, lks Front Back: Right Side: Left Side:
EETAILED' ,DESCRIPTIO.N'� F WORK:
Remoy,e and replace existing shingle roof with new.self-adhered underlayment & 26 gauge 5-V metal
panel l,Joof.
CON ;1 RUCTION `INFORIVIATIQN:
Additi na wor<to be' ertormed uri &
❑_ VAC Gas Tank
❑ lectric 0 Plumbing
Total S , . Ft of Construction: 2,100
Cost o Construction: $ 12k
t is permit - check aO
ec<a apply:
❑Gas Piping _ Shutters
Sprinklers ❑ Generator
S Ft. of First Floor: _
UtilitiesInSewer ❑Septic
❑ Windows/Doors
R1Roof 5 in 12 Roof pitch
Building Height:
-,OWNER/LESSEE:
CO:NTRAGTOR3
Name
Addrdl
City: Fort
Zip Co
Phone
E-Mail'
Fill in fre
from t
„ ary L & KimballMary Jane M Kimball
Name: Rene Reyes
5605 EASTWOOD DR
Company: MY FLORIDA ROOFING LLC
Pierce State:FI
e: 34951 Fax:
No.772-480-0950
Address: 601 21st Street Suite 300
City: Vero Beach State. FI
Zip Code: 32960 Fax:
Phone No. 772-453-7219
simple Title Holder on next page ( if different
Ile Owner listed above)
E-Mail: cs@myflroofingcontractor.com
State or County License: CCC1326546
If value lof construction is $2500 or more, a RECORDED Notice of Commencement is required.
,SU�, PLEMENTAL.CON'STRUCTI,O.N LfE,,N LAW IN,•FORMATION':
DESIGNER/ENGINEER: _ Not Applicable
N a rr e: Gary L & KimballMary Jane M Kimball
MORTGAGE COMPANY: Not Applicable
N a m e: Rene Reyes
Add bless: 5605 EASTWOOD DR Fort Pierce FI
Ad d ress : 5605 EASTWOOD DR
City:IFortPierce
Zip:
State:
H Phone
lil
City: Vero Beach State:
Zip: Phone:
FEE
Name:
Ad d
City:11
Zip:
ll
SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
re ss : 601 21 st Street Suite 300
Address:
11 Phone:
City:
Zip: Phone:
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!R/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
f that no work or installation has commenced prior to the issuance of a permit.
County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
e. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
deration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
dance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
owing building permit applications are exempt from undergoing a full concurrency review: room additions,
ry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
IING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
dements to your property. A Notice of Commencement must be recorded and posted on the jobsite
the first inspection. If you intend to obtain financing, c�uullt with lender attorney before
Pnrinu %Atnrk nr rprni-ding vu nr Nntirmm p of CnPnr _ �fnPnt_
Signal
ure of Owner/ Lessee/Contractor as Agent for Owner
Signa ure o Contractor/Lic nse Holder
STA
E OF FLORIDA
STA OF FLORIDA
CO i,NTY
OF
COUNTY OF Mo4
The forgoing
instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this
day of 20_ by
this lQ day ofS-SAE nor , 20j45by
Name of person making statement
Name of person Aking statement
Personally
Known OR Produced Identification
Personally Known >_OR Produced Identification
Type
Identification
Type of Identification
Produced
Prodil
ced
(Sigr
ature of Notary Public- State of Florida)
i nature of N ary Public tat@t rida )
S
Com
iission No. (Seal)
•�nl Brook Gentile
Commission No. 217=;(s99lrymission I GG1112
Expires: June 4, X21
Bonded thru Aaron No
REVIEWS
'I
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DAT
REC
IVED
�]_
DAT
r;
COMjPLETED
il2a
Rev. 872/17