HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
-Date: Permit Number:
Building:Permit-Ap-pficabon:
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 Yes
PERMIT APPLICATION FOR: Roof
PROPQSEQ IMPROVEMENT LQCATIQN
-`� ,p
Address: Z(C0 c� 47"
Legal Description:
Property Tax ID#: dZ– I (3 Q G 00 2 Lot No. 4 Z
Site-Plan Name-., N/a Block-No: CO
Project Name: N/a
Setbacks Front N/a Back: N/a Right Side: N/a Left Side: N/a
DETAILED DESCRIPTION OF WORK 3 'W r
We will tear off the existing roofing down to the plywood, Re-nail the deck to the current code and Re-roof.
CONSTRUCTION INFOR 'ATLO_N
Additional work to be nprtormed under this permit–check a app y:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
E]Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: (,meq S . Ft.of First Floor: N/a
Cost of Construction:$ 2 s?� OO Utilities: Sewer Septic Building Height: N/a
OWNER/LESSEE f CONTRACTOR ;
Name c Name: Christopher Collins
Address: ;;?74 �C��11 I(�� lo�rl _ Company: Collins Roofing Inc
City: P��— _ State: Address: PO Box 12867
Zip Code: �J Fax:N/a City: Fort Pierce State:FL.
Phone No.N/a Zip Code: 34979 Fax: 772-489-6505
E-Mail:N/a Phone No. 772-201-1352 or 772940-8607
-Fill"in-fee simple Title Holder on next page(if different E-Mail: CollinsroofingincCaCgmail.com"
from the Owner listed above) . State or County License: CCC-058011
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFOATIONRM
R/ENGINEER: d N plicable MORTGAGE COMPANY: d No le
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Phone:
FEE SIMPLE TITLE HOLDER: d_Not Applicable BONDING COMPANY: t 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 the permit holder to build the subject structure
which_is_in conflict with-any applicable.Home Owners_Assoclation 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 bu' pe it a i ions a exempt from undergoing a full concurre view:roo 110
accessory st tures,swim g pools,fenc ,walls,signs,screen rooms and acc ory uses t ther non-resid ntial use
WAR G TO OW :Your failure t Record a Notice of Comme ement m re ult in your payi twice for
imp vements o r property.A otice of Commencemen ust be r ord d and posted the jobsite
b ore the f ction. If i end to obtain financin consult n er or an attor ey before
ommen a r or rec g ur Notice of Commenc ent.
Xzw� s
'���*'�'""� nt Si Contract r nse Holder
STATE OF FLORIDA,: STATE OF FLORIDA
COUNTY OF COUNTY OFL-�-� -
The forgoing instr1�'��11was acknowledged efore me The forgoing instrument was acknowledged before me
this.a day of v l 20 �y this k )�day of J 20 Ro by
(Name of person acknowledging) (NgMe ofperson acknowledging)
4� 5",L fte__�
(Signature ary Public-State of Florida) ature of Notary Public-State of Flori a
Personally Known OR Prod u ed Ider<'fication Personally Known OR Produced Identification
Type of Ider tifif ort' ro Type of Identification Produced 'If L01— c_ti-45a ��b�io3830
,.�ot►,pr ale`
Commissi 1°: Notary Public-Stat1�I rlda Commission No. ���q�'9`f�(�i (Seal)
Z C0111111 Ion#FF 221708
My Comm.Expires May 10,2019
00110110 umilin National Notary Assn.
Revised 07/15/20 4 -Stu@ o1'AwIft
CaMMI I bn f!N:9+9412
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