HomeMy WebLinkAboutbuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date: Permit Number: �C 3 - 6S( 1
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Building Permit Application 8161 61 8VH
Planning and Development Services 43AI 78
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 1206 FLEETWOOD LANE, FORT PIERCE
Legal Description: DRIFTWOOD MANOR-SECTION ONE LOT 1
Property Tax ID#: 3404-806-0001-000-0 Lot No.
Site Plan Name: Block No.
Project Name: GONZALEZ/RE-ROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
TEAR OFF SHINGLE, RE-NAIL DECK. INSTALL NEW OWENS CORNING DURATION SHINGLE
ROOF SYSTEM OVER 30# FELT UNDERLAYMENT. REPLACE ONE SKYLIGHT
CONSTRUCTION INFORMATION:
Additional work toe er orme under un this permit—checka appy:
HVAC 11 Gas Tank []Gas Piping In Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers M Generator Z Roof 5/12 Roof pitch
Total Sq. Ft of Construction: 5,200 SFt. of First Floor: 2,541
Cost of Construction: $ 15,625 Utilities:Sewer Septic Building Height: 1 STORY
OWNER/LESSEE: CONTRACTOR:
Name ROGELIO GONZALEZ Name: KYLE WHITE
Address: 1206 FLEETWOOD LN Company: J.A.TAYLOR ROOFING INC
City: FT PIERCE State:FL Address: 302 MELTON DRIVE
Zip Code: 34950 Fax: City: FORT PIERCE State: FL
Phone No. 772-216-1667 Zip Code: 34982 Fax: 772-468-8397
E-Mail: RGONZALEZ@COASL.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: CCC1325895
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: L Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ of Applicable BONDING COMPANY: CAot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 ins on you intend to obtain financing, consult with lender torney before
commencin w rec in our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signatu of Con ractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 13 day of MARCH 20_ by this 13 day of MARCH 20_ by
KYLE WHITE KYLE WHITE
Name of person making statement Name of person making statement
Personally Known xx OR Produced Identifi Personally Known xx OR Produced Identification
Type of Identification ,� MA �s Type of Identification
Produced ��` �' NRFS9d�°'i Produced ��,
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(Signature of Notary Public-State of FlorJda), ;<FF 933�'S ASig ature of Notary Public-State of.F*ofida) •A
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Commission NO. FF 936050 dF COmmI5510n NO. FF 936050 �� �k� p1J. s
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17