HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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 x
PERMIT APPLICATION FOR: Roof
Address: 5272 Fourwinds Way Fort Pierce, FL 34949
Legal Description: Sec10 Town 34S Range 40E
Property Tax ID #: PARCEL ID: 1410-502-0081-000-4
Site Plan Name: John R or Faith C Hudspeth
Project Name:
Setbacks Front Back
Right Side: Left Side:
Lot No.
Block No.
Remove existing shingle roof. Install . i (CY—Wyl 54�/ hf
Install IKO storm shield self -adhering modified shingle underlayment.
Install IKO Cambridge lifetime shingles per code.
PITCH 3/12
IditlonaI work to be nertormed under this permit — check all apply:
HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers ❑ Generator W1 Roof
Total Sq. Ft of Construction: 1150
Cost of Construction: $ 4,750.00
Sq.
of First Floor: _
Utilities: DSewer OSeptic
Name: John R. or Faith C. Hudspeth
Address: 401 Whip O Will Way
City: Reidsville State: NC
Zip Code: 27320 fax:
Phone No. 336-280-1171
E -Mail: jhudsl2345@me.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: GARY MARZO
Building Height: 13 ft.
Company: GARY MARZO, INC.
Address: 861-A SW Lakehurst Drive
City: Port St. Lucie State. FL
Zip Code: 34983 Fax: 772-465-8829
Phone No. 772-871-2489
E -Mail: gmarzoinc@aol.com
State or County License: CC -C058193
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
5,3'7,3 -F z-rttll ,As 'l-``
MORTGAGE COMPANY: _ Not Applicable
Name: _
Address:
City:
Zip:
Phone:
State:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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.
_ Signature of Owne I
ssee/Agent
STATE OF FLORIDA
CO U NTY OF ST Luc E
The forgoing instr was acknowledged before me
this day of 20 /& by
DAVID VANDERPIER
(Name of'p�PNotary
g )
(Si atu olic- State of Florida )
Personally Known x OR Produced
Type of Ideptjt1,@Aon PLoq
Commissio fgo. `_? MY COMMISSION ff
'�Y9550
EXPIRES March 9, 2018
Revised 07/15/2014
�" k4lel__ s
Signature o ontrct r Licens older
STATE OF FLORIDA
COUNTY OF ST LUCRE
The forgoing instrument as acknowledged before me
this a&day of 20 /& by
DAVID VANDERFLIER
(Name of person acknowledging)
(Signature of Not Public- State of Florida )
Personally Known x OR Produced Identification
Type of Id —
>?o�"aYP"°L�; DAVID VANDFRFLIER
CNo INAY COMMISSION #F�450
EXPIRES March 9, 2018
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