HomeMy WebLinkAboutBuilding Permit Application i
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i l
Date: Permit Number:
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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 ReSidentia
PERMIT APPLICATION FOR: Roof
P:t OOO5Eb 1MPRdV ENT LOCATIOWWNWN
Address: 8595 Gallberry Circle, Port St Lucie
Legal Description: Savannah Club Plat Three Blk 24 Lot 2 (OR713-2461)
Property Tax ID#: 3425-703-0125-000-4 Lot No.2
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Site Plan Name: i' Block No. 24
Project Name: Reroof
Setbacks Front Back: Right Side: Left Side:
�I TAILEQ DE �RIPT1, OF WORK
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Remove existing roof material to deck; renail to code. Install 301b felt with double dry in. Install
new shingles.
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CtN�TFtUCT)ON INFORMATION 6 "
Additionalworkto e e orme under t is permit—c ec a appy:
11HVAC Ei Gas Tank 0Gas Piping _Shutters Q Windows/Doors
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Electric Plumbing Sprinklers 0 Generator l, Roof
Total Sq. Ft of Construction: 1339 Sq. Ft.of First Floor:
Cost of Construction:$ 5796.32 Utilities: _Sewer Septic Building Height: 12'
Cj1NER/LESEE•� y Yb3{ 4 �tONTRACTC3F W, }
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Name Robert Sampson Name: Douglas E Roe
Address:8595 Gallberry Circle Company: Code Red Roofers Inc.
City: Port St Lucie State:FL. Address: 3341 SE Slater St
Zip Code: 34952 Fax: City: StuartI State:FL
Phone No.772-285-8094 Zip Code: 34997 Fax: 772-287-7763
E-Mail: Phone No. 772-287-2829
Fill in fee simple Title Holder on next page(if different E-Mail: becky@cgderedroofers.com
from the Owner listed above) State or County License: CCC1326574
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIO .
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: iPhone-
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 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 our Notice of Commencement.
_Signature of Owner/Lessee/Agent SignA re of Contor/License Holder
STATE OF FLORIDA�` STATE OF FLO!7%kke)
COUNTY OF 1 } L�c.�-s=ue COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was a/,c,k-n'o'wledged before me
� o6P—
thi� day of CC�er 20 Eby this day of l�1�1/P�')?/ Y ,20 &by
� P_� � (-\\. - a
(Name of person acknowledging) (Name ofpbrson acknowledging)
(Signature of Notary Public-State of Florida) (Signat re of Notary Public-State f FI id )
Personally Known ✓ OR Produced Identification Personally Known, OR Produced Identification
Type of Identification Produced Type of Identification Produced
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Commission No. —L` ."�a�Poe., ($eP*RICIA M.GIUNTA ommission No. F�� 7 f 3U io��
_� '�° Notary Public-State o1 Florida �`�<,G�.�eassioti Q,`:
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Commission#FF 095906
Revised 07/15/2014 """ 0-0® *.
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION /'ISE'Q��TURTL°°FpF` �IVI`ANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REUIE@VVlaa�c\\\a`` REVIEW
DATE
COMPLETE
INITIALS