HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11 aa1yp Permit Number:
R E C E I D APP, 2 2 2016
UWCSIA 10
Building Permit Application
Planning and Development Services
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 IMPROUEMENtLOCATION
;1
Address: 5913 Hickory Dr, Fort Pierce, FL 34982
Legal Description: INDIAN RIVER ESTATES-UNIT 08-BLK 69 LOT 23(MAP 34/11S)(OR 373-1024)
Property Tax ID#: 3402-609-0629-000-7 Lot No.23
Site Plan Name: Block No. 69
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILE'lI DESCRIPTION OF WORK f
Reroof- Remove existing roof covering, dry-in with self adhering underlayment and install new asphalt
shingles.
Roof Pitch- 5/12
Product- Owens Corning FL10674-R10 &Soprema (Resisto) FL2569-R10
CONSl'RUCTIONyLNFORMATION.
Additional work to be De rmed under this permit—c ec all appy:
HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 2190 Sq. Ft.of First Floor:
Cost of Construction:$ 8810 Utilities: Sewer Septic Building Height:
OWNER/LESSEE a CONTRACTOR.
r
Name Doris Wagner Name: Michael Miller
Address:5913 Hickory Dr Company: Trade Winds Roofing, Inc
City: Fort Pierce State:FIL Address: P.O. Box 13208
Zip Code: 34982 Fax: City: Fort Pierce State:FL
Phone No.772-464-2400 Zip Code: 34979 Fax: 772-466-9725
E-Mail: Phone No. 772-466-9420
Fill in fee simple Title Holder on next page(if different E-Mail: Mike@tradewindsrooflng.com
from the Owner listed above) State or County License: CC C057399
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
'SI
UPP,LEM`ENTAL CONSTRUCTION LIEN LAW INFORMATION`
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
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 thepermit 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
commenci wo or recording our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature bf Contra License Holder
STATE OF FLOR STATE OF FLORPA� L�AC���
COUNTY OF \L��l{� COUNTY OF
The forgoing instrurlient was acknowledged before me The forgoing instrument was acknowledged before me
this'2�day of irl 20 4by thisa day of YZ 20 by
CY)OLIA M 1 1 k M\Lhou" M
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pub is Sthte of Florida) (Signature of Notary Public-State bt Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced F�� EQ DEE
FELICIA LYNE OANDEE rUBUC
Commission No. NOTMI)PUBLIC Commission No. ST=g FLORIDA
STATE OF FLORIDA � ��FF0512f�i
CarnN!FF+D512B3
Expires 9/4/2017
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS