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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE _COMPLETED FOR APPLICATION TO BE ACCEPTED DatI: Permit Number: il ©' Ola® RC-CeNEo 018 Building Permit Application oermttLu "e u "t Planking and Development Services St. Building and Code Regulation Division / 2300 Virginia Avenue, Fort Pierce FL 34982 _ Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: Roof I' PROPOSED IMPROVEMENT LOCATION: WNNED Addrelss: 835 Se Tierra Ct, Port Saint Lucie Florida 34983 vas Lstul!,9c %JUUMY Legal Description: RIVER PARK - UNIT 7-13LK 65 LOT 12(MAP 34/28S) Propel ty Tax ID #: 3919 'S50 'oOS1 _0(nl? Lot No. Site Plan Name: Block No. ProjecIt Name: Setbalcks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Flat Roof ass : FL$Z-594Z� CONSTRUCTION INFORMATION: Additional ❑HVAC0 work to e nertormed under this permit — check ❑Gas Piping a apply: Shutters ❑ Windows/Doors Gas Tank _ ❑ Electric 0 Plumbing ❑Sprinklers ❑ Generator Roof Roof pitch Total Sq. Ft of Construction: 600 S . Ft. of First Floor: Cost oConstruction: $ 1000 Utilities: _Sewer ❑Septic Building Height: OWN ER/LESSEE: CONTRACTOR: Name aria Downs Name: Dee Keihn Addrelss: 835 SE Tierra Court Company: PDKRoofing.inc City: Port Saint Lucie State: FL Address: 626 Sw Everett Ct. City: Port Saint Lucie State: FL Zip Code: 34953 Fax: Zip Code: 34983 Fax: Phonei No. %7 -W -61e3 E-Mail: Phone No. 7725280113 Fill in fee simple Title Holder on next page (if different from ti he Owner listed above) dkroofin me E-Mail: p g• @gmail.com State or County License: CCC1331408 If valuei 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: Cityi: State: Zip:, Phone City: State: Zip: Phone: FEEISIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable Name: Address: Address: City: City!: Zip: Phone: Zip:, Phone: OWNER/ 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 which its 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 the approved plans, the Florida Building Codes and St. Lucie County Amendments. The fo'lowing building permit applications are exempt from undergoing a full concurrency review: room additions, accessory 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 improvements 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, coryswlt with lender or an Forney before comme ci 1r work or roorclA your Notice of Commenceme 1 �, / i ure of Oyvner/ as Agent for Owner I St ature STATE OF FLORIDA STATE STATE OF FLORIDA C COUNTY OF o�c- , sz, COUNTY OF The forgoing ins ment was acknowledged before me this day of� C� , 202_ by Name of person making statement Personally Known OR Produced Identification Type'lof ldentifi Produced Na_h�J ft4Lrr��. (Signture of Notary Pu Commission No. tary I �Q��jHAHNA INGRAM No�6blic - State of Florid, My Comm. Expires Dec 20, 201 Commission dt Rc� 1 77; onded thr,i„ HoTder The fQQ�-going instrument was acknowledged before me this `mil day of J 20f]S_ by Name of person making statement Personally Known OR Produced Identification Type of Ident' icat'on Produced 1,__ Lit* (Signature of Notary Pu 4a--5t AElorida_)--- LASHAHNA INGRAM e' commission No. '=°4• +`�: Notary qG-421j State of Florida My Comm. Expires Dec 20, 2018 c�a Commission # FF 177249 lF .. nP,�• REVIEWS FRONT ZON NINI G :: SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER I REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATO COMPLETED Rev. 0/17