HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1A "_"
ANNED Permit Number: I ON 007K
SG
s - r- 5•a_ -..-i BY RECEIVED
St. Lucie county
Building Permit Application APR 03 101E
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof III
PROPOSED IMPROVEMENT LOCATION: R II
Address: 15'-Puli4sP ex- lO..Frark wirrp
Legal Description: I_j" ?t�i 3� M I0 1?=R Of 5 3ti1 IAA 44� W V4 5W IIN CFNW t&-te55
Ml I ptD}
Property Tax I D #: 2311237 - MM -1110 -91 Lot No.
Site Plan Name: N/A Block No.
Project Name: N/A
Setbacks Front N/A Back: N/A Right Side: N/A LeftSide: N/A
DETAILED DESCRIPTION OF WORK: . I I I L, III
W e, will - eOX oQP-tom 2XV5rlt1 bdh r i- t r - rym\ ! v t- de.Gk *0 'Code .o-x�
VQ. rpoi wAV- 5-v TVV a)t We b*V4V%Xn 11-MFt 4zn
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CONSTRUCTION INFORMATION: III
HaanionaiworKtooe errormea unaermispermic-cnecKall apply:
�HVAC _Gas Tank ❑Gas Piping _Shutters ❑Windows/D,olors
Electric 0 Plumbing
�� []S rinklefs Generator IV],
Roof T Roof pitch
Total Sq. Ft of Construction: .+f% �Z S . Ft. of First Floor: N/A
Cost of Construction: $ (9, UOO.06 Utilities:Sewer 0Septic Building Height: N/A
OWNER/LESSEE:
CONTRACTOR:
Name 0441
Name: Christopher Collins
Address:
Company: Collins Roofing Inc.
City: V4 .V (d& Z State:
Zip Code:31.040S Fax: N/A
Phone No. N/A
Address: P.O. Box 12867
City: Ft. Pierce State: FL
Zip Code: 34979 Fax: 772-489-6505
Phone No. 772-201-1352
E-Mail: N/A
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: collinsroofinginc@gmail.com
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: rNotApplicable MORTGAGE COMPANY: 4VFNotApplicable
Name: Name:
Address: Address:
City: State: City: Ft. Pierce State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: rNot Applicable
Address: P.G. Box 12867
City:
Zip: Phone:
BONDING COMPANY: rNot Applicable
Address:
City:_
Zip:
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 Coun Amend t'
The followin g permit ap lications are exempt from undergoing a fullAurrenview: roo additionsccessorructures,wgPoofences, wallssigns, screen rooms antoanother on -residential use
ING TO ER: Your failre toRecord a Notice of Com enesultin yo rpaying twice for
irovemen o y ugrope . A Notice of Commencem t med and p ted on the jobsite
efore the n ect �� if y u intend to obtain financI g, cond a ttorney before
comme or rd' a vour Notice of Comme ement.%�
ig re'o 0 e5seelContractor as'Agent or, vinery
Sig at o Contra - r _L_icense Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF I Ci i�
_ i
The fo going instru ent w@s acknowledge before me
th day of 20 by
The forgoing instru a it was cknowledge before me
this day of 20 by
(
n
Name of person aking statement
Name ofrs pemaking statement
Known O Personally R Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signa r to ublic- State of Florida
(Signatur o to
•••" ;,, ••• �SEY FRENCH
Commission O. • �1'p;i. <do�aPl�Nublic—State of Florida
,; •• CASEY FRENCH
, A`a�� Not Pu is —Slate of Florida
COmmISSIOn NO. r �on#GG 167258
Commission # GG 167258
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'.°� ; My Comm. Expires Dec 11, 2021
My Comm. Expires Dec 11, 2021
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go„dede„o,yn Netiorol NomryAss'.
Borden lh,.,b National N.I.gAsn.
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Rev.8/2/17