HomeMy WebLinkAboutBuilding Permit Application ALL 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
PROPOSED IMPROVEMENT LOCATION: f
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Address: 1814 Edgevale Rd Fort Pierce, FL 34982
a 40E
Sec21 Town 35S Ran
Legal Description: 9
Property Tax ID#: PARCEL ID: 2421-802-0026-000-9 Lot No.
Site Plan Name: Georgia K Gulley Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:,
DETAILED DESCRIPTION OF WORK:
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Remove existing shingled roof and flat roof. Install Polyglass/PolyFresko modified on FR.
Install IKO storm shield self-adhering modified shingle underlayment.
Install IKO Cambridge lifetime shingles per code. I
PITCH 2/12 and flat.
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy:
HVAC E] Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 2600 S . Ft. of First Floor:
Cost of Construction: $ 9,610.00 Utilities:cn Sewer[]Septic Building Height: 13 ft.
OWNERAESSEE; CONTRACTOR:
Name: Georgia Gulley Name: GARY MARZO
Address: 1814 Edgevale Rd Company: GARY MARZO, INC.
City: Fort Pierce State:FL Address: 861-ASW Lakehurst Drive
Zip Code: 34982 Fax: City: Port St. Lucie State:FL
Phone No.772-460-9372 Zip Code: 34983 Fax: 772-465-8829
E-Mail: Phone No. 772-871-2489
Fill in fee simple Title Holder on next page(if different E-Mail: gmarzoinc@aol.com'
from the Owner listed above) State or County License: CC-C058193
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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.SUPPLEMENTAL.CONSTRUCTION LIEN LAW INFORMATION:`
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Pihone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone: !
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I certify that no work or installation has commenced prior to the issuance of a permit.
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St. Lucie County makes no representation that is granting a permit will authorize the perm,it 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 concurrencyreview:'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 le'irider or an attorney before
commencing work or recording our Notice of Commencement.
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_Signature of Ow er/Lessee/ a Signature-6fer Con(Fac
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STATE OF FL IDA STATE OF FLO A
COUNTY OF STLUCIE COUNTY OF STLUCIE I•
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this-�L day of 20/_61 by this__L day of 20 /ky
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DAVID VANDERP�IER DAVID VANDERFLIER
(Name of person ack o to 91, g) (Name of person acknowledging
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(Signature 6f Nota ublic-State of Florida) (Signaeorw6f Notary Pu lic-State of Florida)
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Personally Known x 'p e n c Io ersonally Known x ro uce
Type of Identification Pro ud�P�°�: DAVID VANDERFLIE ype of Identifica Q'itP dPAVID RFLI
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"` '� MY COMMISSION#FF09955 �. oQ MY COMMISSION#FF099550
:. . .. ?lF ::-gyp.
Commission No. -.' 'ar�F EXlt�I�S March 9, 201 Commission No. oF�,.. EXPIRES 13H 9, 2018
(407)385.0153 Florldallotm Servlaoxom (407),'398-0153 FloridallotaryService.com
Revised 07/15/2014
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DATE
COMPLETE
INITIALS
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