HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVr
Building Permit Application DEC 0 6
Planning and Development Services 20'6
Building and Code Regulation Division PERMITTING .
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential Yes
PERMIT APPLICATION FOR: Roof
PROPOS✓ED I' PROVEMENT.LOCATION..
Address: p0 — `� k L
Legal Description: Le Ulf aOAD.irV _ AD 1�—� �� She L(�} -7
Property Tax ID#: (OCAS— 03 EQ`wo"- Lot No. Z
Site Plan Name: .N/a Block No. �D
Project Name: N/a
Setbacks Front N/a Back: N/a Right Side: N/a Left Side: N/a
DETALLED DESCRIPTION,�OF WORK ' _
We will tear off the existing ro%ing down to the plywood, Re-nail the deck to the current code and Re-roof�\/lli
v vine- a� r001�V\q,
_CONSTRUCTION_ -INFORMATION
Additional work to be e orme' under this h permit—check a apply:
HVAC E]Gas Tank ❑Gas Piping _Shutters a Windows/Doors
0 Electric 0 Plumbing Sprinklers Generator 21 Roof
Total Sq. Ft of Construction: S Ft.of First Floor: N/a
Cost of Construction:$ �, Utilities,-TiSewer 0 Septic Building Height: N/a
,OUVNER/LESSEE." CONTRACTOR:
Namemu'��Jn oi,s Name: Christopher Collins
Address: Company: Collins Roofing Inc
City: � State: Address: PO Box 12867
Zip Code: . 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: V_Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: V_Not Applicable BONDING COMPANY: V_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 build' permit applications are exempt from undergoing a full concurre evie :room a44
accessory st urns,s 'coming pools,fe _ walls,signs,screen rooms and acce ry uses to arinyo
on-reside tial use
WAR G TOO NE :Yo allure to cord a Notice of Comme ement m e r paying ice for
imp r vement yo r operty.A Notice of Commencemen ust be r co ed nd poste t e jobsite
be re the ' s Ins ion. If y 'nte d to obtain financin consult ith nd or an r y efore
c mmen ' o r recor ' otice of Commenc a .
s
r of_ ner _ee/Agen Signa n or/License Holder
STATE OF FLOR�.D` A STATE OF FLORIDA
COUNTY OF-3k- �•c mss- COUNTY OF Sk- L c,-,-
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this U4`day of Qo Nn� , 20 L(,by this D—day of Dac -rv\�-� ,20 by
(Name of person acknowledging) (Name QLnerson acknowledging)
(S' a of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification`s
Type of Identification Produced FLDL C L(53 IL Type of Identification Produced►-LDL c. -�ESd�l lP 9038
Commission NoFF'� `'( Z (Seal Commission No.gArm
..`o�'" o®� RACHEL TAMARA TAMARA VILLARUEL
�? �•= Notary Public-State o1 Florida * S Notary Public-State of Florida
Revised 0 � ac Commission#FF 949442 ;9 ; Commission#FF 949442
•'••',� d;�' M Comm.Expires Jan 11,2020 MY Comm.Expires Jan 11
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