HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: �CD9,013)9u
�i RECEIVED
Building Permit Application FEB 06 1010
Planning and Development Services
Building and Code Regulation Division permitting �epa�{ment
St. Luele County
2300 Virginia Avenue, Fort Pierce FL 34982
. Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: Roof
Address: 5714 PAPAYA DRIVE, FORT PIERCE
Legal Description: INDIAN RIVER ESTATES -UNIT 09 - BLK 79 LOTS 10 AND 11
Property Tax ID #: 3402-610-0275-000-4
Site Plan Name:
i Project Name: KAMMERER/REROOF
j Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
TEAR OFF SHINGLE, RENAIL DECK. INSTALL NEW JA TAYLOR 5V CRIMP METAL PANEL ROOF
SYSTEM (FL#17443.1) OVER OWENS CORNING WEATHERLOCK TILE & METAL (FL#9777.7)
SELF- ADHERED UNDERLAYMENT. REPLACE SKYLIGHTS
❑HVAC LJ Gas Tank
❑ Electric ❑ Plumbing
Total Sq. Ft of Construction: 5,100
Cost of Construction: $ 21,660
❑Gas Piping Ll Shutters ❑ Windows/Doors
❑Sprinklers ❑ Generator Roof 6/12 Roof pitch
S Ft. of First Floor: 4,492
Utilities:Sewer ❑Septic Building Height: 1 STORY
10
,fER/lE�S"
�CONTRAR# Y.k . h.
Name MATTHEW KAMMERER
Name: KYLE WHITE
Address: 5714 PAPAYA DR
City: FORT PIERCE State: FIL
Zip Code: '34982 Fax:.
Phone No. 772-284-6212
Company: J.A. TAYLOR ROOFING INC
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4040
E-Mail: KAMMERER@BELLSOUTH.NET
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: NADINE@JATAYLORROOFING.COM
State or County License: CCC1325895
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
5��'PPt!El1�fN� �ONS�UCi1QN�i LAW �
a �IV1A�1 ¢ `w }��
DESIGNER/ENGINEER:
Name:
of Applicable
MORTGAGE COMPANY: No plicable
Name:
Address:
City: State:
Zip: Phone:,
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _
Name:
t Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
city:
Zip: Phone:
City:
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: You re to Record a Notice of Commencement may result in your paying twice for
improvements to your rty. A tice of Commencement must be recorded an sted on a jobsite
before the first insp n. If you i nd to obtain financing, consult with lende an attorne efore
commencing w or recording o Notice of Commencement.
SignaVle of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTYOF STLUCIE
The forgoing instrument was acknowledgeAefore me
The forgoing instrument was acknowledged before me
this 3RD day of FEBRUARY 20OUby
this 3RD day of FEBRUARY 208ay
KYLE WHITE
KYLE WHITE
Name of person making statement
Name of person making statement
Personally Known xx OR Produced Identification
Personally Known xx OR Produced Identification
Type of Identification
Type of Identification togvrue NADINEMANRESA
Produced oavPu NADINE MANRESA
P. duced ro''.�'•,�c Commission # GG 3552
,.
* * Commission # GG 355
3 Expires November 15, 2
Expires November15,
11,123 F oP� BondodThruBudgelNotnS
o BondodTtwBu N
'
(Sig ture of Notary Public- State of Florida
I[Sigrfature of Notary Public- State of Florida
Commission No. GG 355203 (Seal)
Commission No. GG 355203 (Seal)
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DATE
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COMPLETED
Rev. 8/2/17