HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2-12,2019 Permit Number: 4 ec aq
RECEIVED
Building Permit Application FEB 1.3 2019
Planning and Development Services 9T, 1,4@ EBNIi€y, Porim€c111q
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 _ _ _
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Roof
Address: 3507 Avenue P Fort Pierce, FI. 34947
Legal Description: Sunland Gardens Blk 19 Lots 6 and 7
PropertyTax ID N: 2405-601-0348-000-5
Site Plan Name:
Project Name: -
Setbacks Front Back:
Right Side: Left Side:
Tear off existing shingle roof, Install Tribuilt Sand SA underlayment FL16048-
Install Owens Corning Tru Definition Dimensional Shingle FL16074-R13
Tear off existing flat roof, install Elastoflex SAV and Polyflex G FL1654-R23
11HVAC 1-1 Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction: 3431
Cost of Construction: $ 17,700.00
Lot No.
Block No.
wisperma— cnecrcan appry:
�GasPiping _Shutters ❑Windows/Doors
[]Sprinklers 1:1 Generator El Roof 3/12 Roof pitch
SFt of First Floor: _
Utilities: L_ISewer E Septic
Building Height:
OWNER/LESSEE: F;; x 4� 3 �r
CONT"' nt( N'
,.. �:.�.
Name Geraldine Brown
Name: Chistopher A. Long
Address: 3507 Avenue P
Company: The Roof Authority, Inc.
City: Fort Pierce State: FI
Zip Code: 34947 Fax:
Phone No. 772-461- 2930
Address: 6771 N. Old Dixie Hwy.
City: Fort Pierce State: FI.
Zip Code: 34946 Fax: 772-468-2247
Phone No. 772-468-7870
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: tra1993Qamail.com
State or County License: CCCO56933
If value of construction is $2500 or more, a RECORDED Notice at Commencement is required.
SUPPLEMENTAL CONSTRUCTION' LIEN'ILAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip:. Phone
State: _
City:
Zip: Phone:
State: _
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 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 the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following 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, cons t with lender or an attorney before
commencing work or recording our Notice of Commenceme
6
Signature of Owner/ Lessee/Contractor as Agent for Owner
i ture Contractor/License Holder
STATE OF FLORIDA
STATE F FLORIDA
COUNTY OF St. Lucie
Y OF St. Lucie
The forgoing instrument was acknowledged before me
The fo�rgging mstrume t was acknowledg before me
day E 20 by
this _ day of 20_ by -
this of C
Christopher A. Long
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
j, L).Suxroy.
(Signature of Notary Public- State of Florida)
(Signature of Notary Public -State of Florida )
Commission No. (Seal)
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Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
City:
Zip:.
MORTGAGE COMPANY: Not
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Address:
City:
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 Count with any applicable Home Owners Association rules, bylaws or an
makes no representation that Is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict dpcovenants 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 following 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-Ifyou intend to obtain financing, cons t with lender or an
rnmmenrinp wnrk nr r n ding vnur Nntire of Commencemen . A
o
FEB 19 2019
Signature of Owi er Lesse /Contractor as Agent for Owner
i ture Contractor/License Hol a Lucie County, Permitti
STATE OF FLORI
STATE F FLORIDA
COUNTY OF St. Lucie
OF St. Lucie
The forg instrument was acknowledged before me
y
The for ing instrument was acknowledge before me
ZO by
this J— d of G a u , 20� 6y
this j c�day of G c
Christopher A. Long
Name of per n making statement
Name of person making statement
Personally Known 4 OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
roI yrj ., L,) Su zrw,
(Signature of Nlatary Public -State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. T'II othyW.Sutton
eW&ARY PUBLIC
PWywSutlon
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Commission No. Ilfs�91BZ pRr S1�#OFFLORIDA
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