HomeMy WebLinkAboutBUILDING PERMIT APPLICATION_S.
ALL APPLICABLE INFO MUST BE i;uMPLETED FOR APPLICATION TO BE ACCEr rc`J It
Date: SL;ANNED Permit Number: I
o N - -r' •,=_ -- - BY RECEIVED
St: Lucie County
Building Permit Application JUL 112019
Planning and Development Services [�7. Lucie County, Permitting
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
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:_
Property Tax ID #: — J
Site Plan Name: N/A
Project Name: N/A
Setbacks Front N/A, Back: N/A Right Side: N/A Left Side: N/A
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L DETAILED DESCRIPTION OF WORK:
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uv�cler-lc�ti-,.�o_v1-1- wick -ice 5V 'tn\ `"�cc3�.u�q,
CONSTRUCTION INFORMATION: III
❑HVAC ❑Gas Tank ❑Gas Piping ❑Shutters ❑Windows/Doors
Electric ❑ Plumbing ❑Sprinklers ❑ Generator Roof ❑ Roof pitch
Total Sq. Ft of Construction: ) S Ft. of First Floor: N/A
Cost of Construction:$(o�(, (�(7' Utilities:�Sewer❑Septic Building Height: N/A
OWNER/LESSEE:
CONTRACTOR:
NamePM(,;ii0_ 1- 5kr t (,Oniurc �^1� .l wbYo fny'�_,(
ame: Christopher Collins ,
Address:—� !�) `d. 1fQ
Company: Collins Roofing Inc.
City: It f)V V, 'VArc-P. Stater
Zip Code: _2)(ALU _ Fax: N/A
Phone No. N/A
Addresse- 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 CONSTRU
DESIGNER/ENGINEER:
Name:
Address:
City: State:
Zip: Phone
LAW INFORMATION:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: Ft. Pierce State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: W Not Applicable I BONDING COMPANY: V'Not Applicable
Address: P.O. Box 12867
City:
Zip: Phone:
Address:
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; l do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida 80clirig Codes and St. Lucie County Amendments.
The following build'buildine permit appf 'cis are exempt from undergoing a full concur- eview: room additions,
accessory s ttures, s ng pools, cites, walls, signs, screen rooms and a ssoryuses to on
use
WA NG TO N R: Your failur to Record a Notice of Com ncement suit in you paying twice for
I
mprovement yo r property. Notice of Commencem must be r ed and pos d on the jobsite
re thefsp ctio you ntend to obtain financi g, consul t e dernaorneybeforeenc r e our Notice of Comme ement.
i of Owner/lessee/Contractor as Agent for Owner
atu a Contractor/License Holder
STATE OF FLORIDA
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STATE OF FLORIDA
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COUNTYOF IY�[A� l
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The forgoing instrumt ryas- acknowledg d before me
this f Q Say of 20 by
The for mg instrument w acknowled ed before me
this Ray of 20� by
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C"risp,
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Name o person making statement
Name o person mak ng statement j�
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Ident'fica
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Type of Id e fic on
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Produced �Yj
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(Signatur�b�te cp Florida
Commission No.
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Commission No&rw BEV LYlArof
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M Comm. iresju114,2021
,n aontlaa tarauph Notional Notary Nva
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Rev. 8/2/17