HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
'S
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
1300 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: 706 ANITA STREET, FORT PIERCE
Legal Description: 3 36 40 FROM NW COR HUNTS S/D RUN N
S 170 FT, TH W 100 FT, TH N 170 FT TO POB
Property Tax ID #: 3403-332-0007-000-5
Site Plan Name:
Project Name: GOLDEN/REROOF
FT, TH E 600 FT TO POB TH CONT E 100 FT, TH
Setbacks Front Back: Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: II
TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW OWENS CORNING DURATION SHINGLE
(FL#10674.1) ROOF SYSTEM OVER 30# FELT UNDERLAYMENT (FL#12328.7).
CONSTRUCTION INFORMATION: III
1:JHVAC
U Gas Tank
❑Gas Piping
Name: KVLEWHITE
Shutters
Windows/Doors
I�IElectric
ED Plumbing
OSprinklere
Generator
Roof3/12 Roof pitch
Total Sq. Ft of Construction:
2.500
5pn of First Floor: 2,372
Cost of Construction:$
7,900
Utilities:Sewerl:]Septic
Building Height: lSTORY
OWNER/LESSEE:
CONTRACTOR:
Name AURAGOLDEN
Name: KVLEWHITE
Address: 708 ANITA ST
Company: J.A. TAYLOR ROOFING INC
City: FORT PIERCE State: FL
Zip Code: 34882 Fax:
Phone No. 772-489-2374
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4040
E -Mail: AURAGOLDEN08ELLSOUTH.NET
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
E -Mail: NADINE@JATAYLORROOFING.COM
State or County License: CCC1325895
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_Not Applicable
MORTGAGE COMPANY:
Name:
_ Applicable
Address:
STATE OF FLORIDA
Address:
COUNTY OF swcle
City:
Zip: Phone
State: _
City:
Zip: Phone:
State:_
FEE SIMPLE TITLE HOLDER:
Name:
_ of Applicable
BONDING COMPANY:
Name:
_ of Applicable
Address:
Address:
Name of person making statement
City:
Personally Known xx
Type of Identification
City:
myer
Zip: Phone:
.::
..........
zip: phone:
Produced
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 Count makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in confylict with any applicable Home Owners Association rules, bylaws or ancovenantsthat 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 yo roperty. A Notice of Commencement must be recorded and posted on the jobsite
before the first 1 ction. f you intend to obtain financing, consult with lende r an attorney before
commencm or rec in our Notice of Commencement.
Rev. B/z/17
Signature of Owner/Lessee/Contractor as Agent for Owner
Signature of Contra
nse Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF swcle
COUNTY OF sT wcle
The forgoing instrument was acknowledge me
The forgoing instrument was acknowledgeQ.lj2fore me
this TTN day of NOVEMBER zD Irby
this TTR day of NOVEMBER
201LY by
KYLENAME 11111111
KYLE WHITE
Name of person making state NE RF
Name of person making statement
Personally Known xx OR Prod
Type of Identification — quo Iq �q'J%
Personally Known xx
Type of Identification
OR Produced I
myer
cation
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Produced � o'-.
Produced
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(Signature of Notary Public- State of STN �Cty\y�P``
(Signature of Notary Public -State of H �A..�y •: Q
ibnyyr!..•. Pp`
Commission No. EE meoso (Seal)
Commission No. rr saeaso
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
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DATE
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DATE
COMPLETED