HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 400 3 '
Building Permit Application � o�tiotio t
Planning and Development Services �� e�
Building and Code Regulation Division o► pe4a�r y
2300 Virginia Avenue,Fort Pierce FL 34982 pet St.�9�e GAJ
Phone: (772)462-1553 Fax: (772)462-1578 Commercial XX Residential
PERMIT APPLICATION FOR: Roof
aaosEoour ' ocaTt � � � � � �
Address: 3500 NW SHINN ROAD, FORT PIERCE (PUMP HOUSE)
Legal Description:, 30 35 39 FROM SW COR OS SE 1/4 RN N 00 DEG 21 MIN 46 SEC W ALG 1/4 SEC LI 2042.03 FT TH S 83 DEG 11 MIN
59 SEC E 88.28 FT TO PT ON E RNV LI OF SHINN RD AND POB,THE N 06 DEG 48 MIN 01 SEC E ALG E RNV I OF SHIN RD AND POB,AND MORE
Property Tax ID#: 2330-421-0001-000-0 Lot No.
Site Plan Name: Block No.
Project Name: CIRCLE H/REROOF
Setbacks Front Back: Right Side: Left Side:
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TEAR OFF 5V METAL PANELS, RENAIL DECK. INSTALL NEW JA TAYLOR ROOFING EDGE-LOC
STANDING SEAM METAL PANEL ROOF SYSTEM (NOA#18-1023.17) OVER OWENS CORNING
WEATHERLOCK TILE & METAL (FL#9777.7) SELF-ADHERED UNDERLAYMENT.
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u" Y '�y -ems z, a 1_ •, '
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itiona wor to er orme under this permit—check a appy:
HVAC -Gas Tank []Gas Piping _Shutters Windows/Doors
Electric ElPlumbingSprinklers Ei Generator W1 Roof 4/12 Roof pitch
Total Sq. Ft of Construction: 200 Sq. Ft.of First Floor: 80
Cost of Construction:$ 1,000 Utilities: Sewer Septic Building Height: 1 STORY
OU1INfRfL�SEECONTRAOR � 41 M
Name WHITE MARSH LLC/CIRCLE H CITRUS Name: KYLE WHITE
Address: PO BOX 14049 Company: J.A. TAYLOR ROOFING INC
City: FORT PIERCE State: FL Address: 302 MELTON DRIVE
Zip Code: 34979 Fax: City: FORT PIERCE State:FL
Phone No. 63-381-2179 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: CCC1325895
If value of construction is$2560 or more,a RECORDED Notice of Commencement is required.
SUR P.0 ETAL C®IUSTRl1C1'I®IV N,L�►U1l iNF;C1RiVIP►T IORI sn6
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DESIGNER/ENGINEER: of Applicable MORTGAGE COMPANY: k-146t Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ of Applicable BONDING COMPANY: _ of 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 OWN :Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to urgperty. A Notice of Commencement must be recorded and post n jobsite
before the firs specIfyou intend to obtain financing, consult with lender or a orn fore
commenci ork or rrdin our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/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 25TH day of FEBRUARY 20QQ by this 25TH day of FEBRUARY 200 y
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
Produced P oduced
Sig ature of Notary Public-`State of Florida) NADINEMANRESA (Si nature of Notary Public-State of Florida)
Commission No. ESA
GG 355203 z°�:RrPUB�'� SeD�lmmIsslon#GG 355203 vau ADINEMANR355
( Commission No. GG355203 01�:••.mac dp i ion#GG 355203
* * ire5 November 15,202
Exp * Expires November 15,2023
116�4' 0
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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