HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED yy��
Date: Permit Number: FJ
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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
PRO POSED"IMPROVEMENT1OCATION.
Address: 5704 TRAVELERS WAY, FORT PIERCE, FL 34982
Legal Description: PALM GROVE S/D BLK B LOT 15
Property Tax ID#: 3410-503-0060-000-0 Lot No.15
Site Plan Name: Block No. B
Project Name: CONSTANTINE RE-ROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION.-O,F WORK
TEAR OFF SHINGLE ROOF . RE—NAIL DECK. INSTALL NEW_OWENS CORNING OAKRIDGE
SHINGLE ROOF SYSTEM OVER_30# FELT UNDERLAYMENT. (4/12 )
CONVSTRUCTION;INFORMATION::: `as `e �fig'f
Additionalworkto e e orme under this permit—check a appy:
HVAC Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator R1 Roof
Total Sq. Ft of Construction: 2200 SFt.of First Floor: 1135
Cost of Construction:$ 7040 Utilities: Sewer Septic Building Height. 1 STY
OWNER LESSEE
CONTRACTQR a
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Name 5 T� n'�Ln
Name: KYLE WHITE
Address:__ 57o VVk/ete_('5 V / Company: J.A.TAYLOR ROOFING INC
City: -E- QlfwiStater— Address: 302 MELTON DR
Zip Code:� `f 0 g2 Fax: City: FORT PIERCE State:FL
Phone No.I Zip Code: 34982 Fax: 772-468-8397
E-Mail:NADINE@JATAYLORROOFING.COM 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 CONSTRUCTIONcLIEN L41N 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 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
commencOg work or recording our Notice of Commencement.
A, I A(i
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Sfin4ture of Owner/Lessee/Agent Si a ure of ontractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCIE COUNTY OF -LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this .2 day of lUza��',M 60—i,-60—i,—, 20 L fiby this day of Iva✓e-rA_Jr �( .20 L----by
KYLE WHITE 1 KYLE WHITE
(Name of person acknowledging) (Na of person acknowl 'ng)
(S' n ture of NotAry Public-Sta of Florida) 'gnature of Notary Publ -Sta a 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 ...ikyPu.,�(Sea[)VALERIEJDELGADO Commission No. GG063270 (Seal)
* #MY COMMISSION#GG 0632
°last P4ee� VALERIE J DELGADO
OF F�°� Bonded Thor Budget Notary Services * *MY COMMISSION#GG 063270
Revised 07/15/2014 �� °e EXPIRES:May 14,2021
9r1OF F' Bonded Thru Budget Notary SeMm
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS