HomeMy WebLinkAboutBUILDING PERMIT APPLICATION,z
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 18 l9 •t� • ti� SCANNED Permit Number:
BY
" I - M-00 St. Lucie County
Building Permit Applicatio E 11 Din"
Planning and Development Services
Building and Code Regulation Division J U N 19 2918
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x A FNpfilft<Mg n� ��__nartment
PERMIT APPLICATION FOR: Roof I J`' `Uu �Ww"''r ' — I
PROPOSED IMPROVEMENT LOCATION:
Address: 4950,4948,4952 Sparkling Pines Circle Fort Pierce, FI.
Legal Description: Twn/Sec/Rgn 18/34S/40E Bldg 11
Property Tax I D #Z: 1418-231-0001-0
Site Plan Name:
Project Name: Heatherway Bldg 11
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I
Remove existing 3 tab shingles, Re -nail wood deck. Dry -in with self -adhered underlayment. Tri Built
Sand SA FL16048-R6. Install Owens Corning Supreme 3 Tab Shingles FL10674-Rl3
I CONSTRUCTION INFORMATION: I
L_IHVAC L=.1Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction: 2368
Cost of Construction: $
9695.20
Gas Piping ❑ Shutters ❑ Windows/Doors
Sprinklers ❑ Generator Roof 3:12 Roof pitch
Sqi -F-t.� of First Floor:
utilities: Sewer ❑Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Heathenvay Ft. Pierce, Ltd.
Name: Christopher A. Long
Address:200 Witmer Road
Company: The Roof Authority, Inc.
City: Horsham State: PA
Zip Code: 19044 Fax:
Phone No. 772-468-2333
Address: 6771 North Old Dixie Hwy
City: Fort Pierce State: FL
Zip Code: 34946 Fax: 772-468-2247
Phone No. 772-468-7870
E-Mail: heatherwayftpierce@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:.tral 993@gmail.com
State or County License: CCCO56933
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
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 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, consult with lender or an attorney before
commencing work or recording; your Notice of Commencement. i) it
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF St. Lucie
The fo Ing instryylent was acknowledged before me
this I day of F'f��j 20 hby
Laura Buclerus
(,M1{Naame o�f/person
acknowledging ) O�w/n�e/riL�ess1seeee/Agent Printed Name
(Signature of Notary Public- State of Florida I
Personally Known
Type ofldentiFlcat
Commission No.
Revised 07/
OR Produced Identification N
VERONICA L. LICONA
Notary Publi(SiarAof Florida
Commission # GG 077156
My Comm. Expires Jun 21, 2021
STATE OF FLOI�P
COUNTY OF ucie
The forgoing instrume t was acknowledged before me
this_& day of P � 20 _L8 by
Christopher A. Long
(Name of person acknowledging) Contractors Name
(Signature of Notary Public- State of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
�(; VERONJ(AL I�[ONA
COmm1551nn No. ?s ¢': Notary PubAcr?R,4d ofEloridi
Commission A GG 077156
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