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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED II
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
PERMIT APPLICATION FOR: Roof
PROPOSfD;INIPROVEMENT LOCATION;: :.
Address: 13976 Clavell Ave, Fort Pierce, FL 34951
Legal Description: Spanish Lakes Fairways SECT 6&7 TWP 34 Range 39
Property Tax ID#: 1306-111-0001-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAI,LED�DESCR,IPTIO N OF-WORK
Reroof- Remove existing roof covering, Dry-in with self adhering underlayment,,and install new asphalt
shingles.
Roof Pitch- 3/12
Product Approval- Shin les-FL10674-R10 / Underla ment- ;�7L:av5D_Q-' �D,CONSTRUCTION"INFORMATION:
Additional work to ff
orme un er t is permit—c ec a appy:
11HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 1316 S . Ft.of First Floor:
Cost of Construction:$ 5490 Utilities:cn Sewer Septic Building Height:
OWNER/LESSEE: : CONTRACTOR-
Name-Wynne
ONTRACTOR:NameWynne Building Corp&Alfred SylviaName: Michael Miller
Address: 13976 Clavell Ave Company: Trade Winds Roofing; Inc
City: Fort Pierce State:FL Address: P.0 Box 13208
Zip Code: 34951 Fax: City: Fort Pierce State:FL
Phone No.772-467-1147 Zip Code: 34979 Fax: 772-466-9725
E-Mail: Phone No. 772-466-9420
Fill in fee simple Title Holder on next page(if different E-Mail: Mike@tradewindsroofing,.com
from the Owner listed above) State or County License: CC C0,57399
alue of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I
SUPPLEMENTAL CONSTRUCTION LIEN 1AW.INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY; _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
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 thepermit 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 insp tion. If you intend to obtain financing, consult 1th lender,or an;attorney before
commenci workW record ina our Notice of Commencement.
21Z ZI/ s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIQA ,, STATE OF FLOR A
COUNTY OF �!Q�l; ,` COUNTY OF ��e�
The for-going instr ment was acknowledged before me. The forgoing instrument was acknowledged before me
this day of 20 nby this-day of 20 A71-by
�
cha Q � � LL ffifflQ9
(Name of person acknowled ing) M (Name of person acknowledging)
_ —
(Signature of Notary Public-Sta a of Flori a) (Signature of Notary Public-Stat o Florida)
Personally Known OR Produced Identification Personally Known V/OR Produced Identification
Type of Identification Produced Type of Identification Produced
LQI��LYNE GANDEE CEBIE GANDEE
Commission No. RYPUBLIC Commission No. � r FELT
-ESTATE OF FLORIDA NOTARY PUBLIC
STATE OF
Comm FF0511283 Expires 914/2017 ► FF051�3
Revised 07/15/2014 Expires 9/4/2017
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
JINITIALS