HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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 X
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENTLOCATION: :
Address: 6502 FORT WALTON AVE
Legal Description: LAKEWOOD PARK UNIT 10 BLK 121 LOT 14
Property Tax ID#: 1301-612-0067-000-3 Lot No.14
Site Plan Name: Block No. 121
Project Name: JOY-SHACKLEFORD RE-ROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION:OF WORK
TEAR OFF SHINGLE. RE-NAIL DECK. INSTALL NEW OWENS CORNING OAKRIDGE SHINGLE
ROOF SYSTEM OVER 30# FELT UNDERLAYMENT. (5 / 12 )
CONSTRUCTION INFORMATION
i,
Additional work toa er orme under this permit—check a appy:
OHVAC E] Gas Tank Gas Piping _Shutters Windows/Doors
11Electric0 Plumbing1:1 Sprinklers E Generator RI Roof
Total Sq. Ft of Construction: 3500 SFt.of First Floor: 1632
Cost of Construction:$ 10000 Utilities:cn Sewer E]Septic Building Height: 1 STY
OWNERAESS,EE: „n CONTRACTOR:.
Name CATHERINE JOY-SHACKLEFORD Name: KYLE'WHITE
Address:6502 FORT WALTON AVENUE Company: J.A.TAYLOR ROOFING INC
City: FORT PIERCE State: FL Address: 302 MELTON DR
Zip Code: 34951 Fax: City.-- FORT PIERCE State:FL
Phone No.772.519.0867 Zip Code: 34982 Fax: 772-468-8397
E-Mail: Phone No. 772-466-4040
Fill in fee simple Title Holder on next page(if different E-Mail: NADINE@JATAYLORROOFING.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: pu
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 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
commencingw rk or recording our Notice of Commencement.
";L�_" ILI L, s
_Signature of Owner/Lessee/Agent Sign ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The forgoing instru ent was acknowledged before me The forgoing instrument was acknowledged before me
this 2— day of o erg - 20 aby this-- day of NW0,Y 20 17 by
KYLE WHITE 1 KYLE WHITE
(Name f person acknowledging) (Name of person acknowledging)
(Sig at re of No ary Public to of Florida) (Sig ure of Not ry Publi -Slaee of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No, GG063270 (Seal) Commission No, 00063270 (Seal)
o� v rue�,o VALERIE J DELGADO tia..Pue�, VALERIE J DELGADO
_ o MY COMMISSION#GG 063270
N Q ondEXPIRES;May 14,2021 a��c EXPIRES:May 14,2021
Revised 07/15/2014 9rEOF F�°� Bed Thru Budget Wary Services aF F�° Bonded Thru Budget Notary SeMces
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS