HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: GIq j'w Permit Number: Iro06�da31
I E ,C,- RECER'7D JUN 09.2016
• SCANNELi
Building Permit Application BY
St. Lucie
Planning and Development Services COIinh,
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential -Wes,
PERMIT APPLICATION FOR: Roof —.MO� , b�
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID #: I
Site Plan Name: N/a
Project Name: N/a
Setbacks Front N/a.
IGW��
V lirh 111i
�, AVI N,&&
Back: N/a Right Side: N/a Left Side: N/a
Lot No.
Block No.
We will tear off the existing rroofing down to the plywood, Re -nail the deck to the current code and Re -roof. i/Iz
LJHVAC L=.[Gas Tank UGasPiping
11 Electric 0 Plumbing Sprinklers
Total Sq. Ft of Construction: o 1 too
Cost of Construction: $ 2-1 q 00. 0d
Shutters Windows/Doors
Generator Roof
S Ft. of First Floor: N/a
Utilities: Sewer E]Septic
Building Height: N/a
OWNER/LESSEE:
CONTRACTOR:
Name
a voQp
I Ic
Name: Christopher Collins
Address: -zlr L >'
Company: Collins Roofing Inc
City: c )7 V� 1�e State:
Zip Code: -�i�—I �� Fax: N/a
Phone No. N/a
Address: PO Box 12867
City: Fort Pierce State. FL
Zip Code: 34979 Fax: 772-489-6505
Phone No. 772-201-1352 or 772940-8607
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 52500 or more, a RECORDED Notice of Commencement is required.
h
SUPPLEMENTAL,CONSTRUCTION..LIEN,LAW
INFORMATION;-'
-,
DESIGNER/ENGINEER: d_
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
d_ Not Applicable
Address:
Address:
City:
Zip: Phone:
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: d_
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 ano 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 build permi applica ' re exempt from undergoing a full concurrency review: room additions,
accessorystru res, swimmi ols, fenc , walls, signs, screen rooms and accessory uses to another non-residential use
WARNI TO OWN . our failuret Record a Notice of Commencement may result in your paying twice for
impro ements to y r roperty. A tice of Commencement must be recorded and posted on the jobsite
bef a the first' ion. I5gu i end to obtain financing, consult with lender or an attorney before
STATE OF FLORIDA
COUNTY OF S-F-_ L. , e ; 2
The for oing instruu t was acknowledged before me
this dayof J hr . 20 Eby
(Name of person acknowledging )
(Signature rkNotary Public -State of Florida )
s
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this _ day of . 20 _ by
(Name of person acknowledging)
(Signature of Notary Public -State of Florida )
Personally Known OR Produced Identification J� Personally Known _
Type of Identification Produced �L 1 L Type of Identification
Commission No.
Revised
Notary Public - State of Florida
My Comm. Expires May 10, 2019
Bonded through National Notary Assn.
Commission No.
OR Produced Identification
(Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS