HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: daJ Oa,�
RECEIt'_LD FEB 13 2017
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 - SN '\
PROPOSED IMPROVEMENT LOCATION:
Address: 5808 BALSAM DR
Legal Description: INDIAN RIVER ESTATES- UNIT 09- BLK 80 LOT 14
Property Tax ID#: 3402-610-0305-000-4 Lot No.
Site Plan Name: Block No.
Project Name: MIGGINS/RE-ROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION`OF WORK.:; A ,,
TEAR OFF SHINGLES. RE-NAIL DECK. INSTALL NEW OWENS CORNING OAKRIDGE SHINGLE
ROOF SYSTEM OVER 30# FELT UNDERLAYMENT. (42SQ/6/12 PITCH )
CON_ STRUCTION INFORMATION:
Additional work toe e Orme under this permit—check a appy:
HVAC E]Gas Tank ❑Gas Piping Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers MGenerator Roof
Total Sq. Ft of Construction: 4200 Sq. Ft.of First Floor: 2050
Cost of Construction:$ 10,500 Utilities: 0 Sewer Septic Building Height: 1 STORY
'.,OWNER/LESSEE: 7 CONTRACTOR:
Name GARRY'&LUCIA MIGGINS Name: KYLE WHITE
Address: 5808 BALSAM DR Company: J.A.TAYLOR ROOFING INC
City: FORT PIERCE State: FL Address: 302 MELTON DR
Zip Code: 34982 Fax: City: FORT PIERCE State:FL
Phone No. 772-359-4406 Zip Code: '34982 Fax: 772-468-8397
E-Mail:GWMIGGINS@YAHOO.COM Phone No. 772-466-4040
Fill in fee simple Title Holder on next page(if different E-Mail: NADINEQJATAYLORROOFING.COM
from the Owner listed above) State or County License: CCC 1325895
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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 c1nd posted on the jobsite
before the first ' ti . If you intend to obtain financing, consult with I r r an attorney before
commenci ork or re c rdin our Notice of Commencement.
7�i� s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCIE COUNTY OF ST LUCIE
The f oing instrument wps acknowledged before me The forgoing instly0ent was acknowledged before me
this day of a l�
20 by this X day of ii - 20 T by
KYLE WHITE KYLE WHITE
(Name of person acknowledging) (Name of person acknowledging)
r'
(Signature of Notary Public-State of Florida) ( ig ture of Notary Publicit State of Florida
Personally Known X OR Produced Iden f cat' Personally Known x OR Produced Idq�ptifit�tlgn
Type *`,���votea�(I,ar�►� ejora. Yp �a�°�S,NEMAN)90/
T e of Identification Produced Type of Identification Produced //,,
r SIO
ONF
Commission No. FF 936050 = Cs �" 0�/F 9 COmmisslon No. FF 936050 _v �•2 n1pr 15 rA,•, p
�� a e� � �-•� e
A o:° PIFF 936050 #FF 930050 ° Q�
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