HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r r
Date: January 12, 2017 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:
Address: 2203 Jo Haywood Drive Fort Pierce Florida 34946
Legal Description: CITRUS HEIGHTS S/D LOT 24 (OR 1111-873)
Property Tax ID#: 1432-700-0027-000-4 Lot No.24
Site Plan Name: Block No.
Project Name: Travis- 1323
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
We will tearing off the current 3-tab shingles, and we will be replacing them GAF Sovereign 3-tab
shingles. The existing deck is to remain.
CONSTRUCTION INFORMATION-
Additional
NFORMATION:A itiona work to be performed under t ispermit—check all appy:
HVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors
11 Electric ❑ Plumbing OSprinklers Generator. Roof 412 Roof pitch
Total Sq. Ft of Construction: 35 S . Ft:of First Floor:
Cost of Construction:$ 13,647.59 Utilities: Sewer E]Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Mamie Travis Name: Francis Buchanan
Address:2203 Jo Haywood Drive Company: Buchanan Services
City: Fort Pierce State:FL=°" Address: 775 NW 57th Street
Zip Code: 34946 Fax: City: Fort Lauderdale State:FL
Phone No.(772)405-0117 Zip Code: 33309 Fax: (772) 324-8090
E-Mail: Phone No. (772) 905-2423
Fill in fee simple Title Holder on next page (if different E-Mail: office@pdrhelps.com
from the Owner listed above) State or County Licens CCC-056685
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW 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 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.
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Itorder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF CAkUA COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this�b day o �IU�C' 20 aby this 10 day otV� 1l.LOL 20 by
(Name of person acknowledging) (Name of person acknowledging)
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(Signature of N t ry Public-State of Florida) (Signature of Notar ublic-State of FloridaILIJ
)
Personally Known _OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission;No. (Seal) Commission NoPP Cao Seal
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MY COMMISSION# -920758
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Revised 07/15/2014 '' � EXPIRES September 22,2019 EXPIRES September 22.2019
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