HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST
MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a� W Permit Number:
sLiu--_ -:� - RECEIVd_D DCT 2 X0;6
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 Yes
PERMIT APPLICATION FOR: Roof
PROPOSED,1MPROVEMENT LOCATION.:-.
Address: ,,Y9e FAO-Ch ��V,P1(2fCp
Legal Description: 457
Property Tax ID#: 13 0) ` (1 / - 066 1 ' 0 CDO X 65 Lot No.
Site Plan Name: N/a Block No.
Project Name: N/a
Setbacks Front N/a Back: N/a Right Side: N/a Left Side: N/a
DETAILED DESCRIPTION OF WORK:
We�II tear off the existing roofing tothe�sood,-Re nail the Eleelk to the - �.an Re-roof.
e 0,1\.( oRXdownadSVL l
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CONSTRUCTION INFORMATION:
Additional work toe performed under this permit—check a appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Fv] Roof
Total Sq. Ft of Construction: S . Ft.of First Floor: N/a
Cost of Construction:$ f �•6C7 Utilities:n Sewer[]Septic Building Height: N/a
OWNER/LESSEE: - CONTRACTOR:
Name\N&kQIM �10��4, WQ1rYVUllr Name: Christopher Collins
Address: 3 J062 0�` y\ Company: Collins Roofing Inc
City: a.Boy State:E. Address: PO Box 12867
Zip Code: M52 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: Collinsroofinginc@gmail.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 LAW INFORMATION:
DESIGNER/ENGINEER: d_Not Applicable MORTGAGE COMPANY: d_Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: d_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 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 concurreviOW: Iuoii-1 diiiiiiiuna,
accessory stru es,s 'mmin ces,walls,signs,screen rooms and acc ory uses t anot _ sidential use
WARNI TO OWN :Your fail a to Record a Notice of Comm cement may r It in your payi g twice for
impro ements to r pr rty.- Notice of Commenceme must be reco and posted o the jobsite
bef a the firs a n. If you nd to obtain financi , consult W' eta-e ai y W3 J%Jl
co mencin r r co
ur Notice of Commen ment.
s
u e of Owner essee gent na of Con or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S-I— 1 v COUNTY OF 5-/-, Z—�i c-%e
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this�S—day of r� �0.� 20 -by this�day of 20 L(p by
atID 11
Age" /��r i� n A�" &A,I f
(Name of person ack owledging) (Name of pers n acknowledging)
10--Q -�� ';�" 0 0��� Qz:�2L -ri
(Signature of Nota & blic-State of Florida) (Signature o ry Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification (/
Type of Identification
Type of Identification P
Yp
��� CATHY J R08ERTS {� CATHY J ROBERTS
AY P Oji 1 J�4n(1Y Pp iii
Commission No. s :fir ptarFlc-State of Florlda Commission No. - Motari(gq-State of Florid
Commission#FF 221708Commisslon#FF 221708
'•;�� opo`c My Comm.Expires May 10,2019 " +,� �PaP My Comm.Expires May 10,2019
a oug a on otary ssr• ., tiongedUnWh National Notary Assn.
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS