HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Ea1%911I Permit Number: \Aaa_6S4 q 1_
• FEB 19 2019
Building Permit Applica ion
Planning and Development Services 5T, I,yela !✓oypEy, P@rm
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxx
PERMITTYPE: Roofing -y,,,RAaA SCANNED
PROPOSED IMPROVEMENT LOCATION: B7--
Haaress:
Property Tax ID #: 4502-501-1193-000-7
Site Plan Name:
Project Name: _
DETAILED DESCRIPTION OF WORK:
Remove existing shingles and replace with 26GA 5V Crimped Mill Finish and peel & Stick.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Constructiion:: /,B
Cost of Construction: $
Lot No. 1006
Block No.
_Shutters _Wind ws/Doors
3
_ Generator Roof I a Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR:,
Name Leroy H Dryer
Name: Bruce W. Watley
Address:1006 Nettles Blvd.
Company: Jupiter Island Roofing, Inc.
City: Jensen Beach State: _
Zip Code: Fax:
Phone No.
Address:11708 SE Dixie Highway
City: Hobe Sound State: FL
Zip Code: 33455 Fax: 772-223-0684
Phone No 772-223-0604
E-Mail:
Fill in fee simple Title Holder on nextpage (if different
from the Owner listed above)
E-Mail jupite(slandroofing@wcifi.com
State or County License CCC1327631
If value of construction is $Z500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRU&ION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
xx Not Applicable
MORTGAGE COMPANY:
Name:
)cc Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
tL Not Applicable
BONDING COMPANY:
Name: _
c}�C 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
inaccordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full cbncurrency review: room additions, '1
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Con s Agen for Owner
Signature Contractor/License Holder
ctor
of
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ff IryZ_S S r1
COUNTY OF YY�falz� y�
The forgoing instrument was acknowledged before me
this t`dayof20%ot by
The forgoing instr ment was acknowledged before me
thi((s�I`613ay201g by
�..> , �,.1 h�\•ram
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally KnowiI� OR Produced Identification
—)0—
Type of Identification
Type of Identification
Produced
/ a l' �l . / J
Produced9.
//
///�
g �7 d:" 9. 7 A6v2
(Signature o N t ry Public -State of Florida
(Signature of try Public -State of Florida I
:6."•. BOBBY J PATTERSON
:?' ! rCP�
BOIBIP ATTERSON
Commission No. :
- MY CCIMPJII�SION # FF921154
Commission No. al
•;!ti„�a? EXPIRES September 23, 20t9
• = MY CO MI ION p FF921154
XPIRES 3e tember 23, 2019
(40713
163 Flake
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8-01 97 FlaiOa
1903
W'Y9e^+ce.m^'
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATIO(40'!)
SEA I E
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19