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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� Date:} [Q• Permit Number: 4 �1 - — _ RECErVED Building Permit Application MAR 1 6 2020 Planning and Development Services ST. Lucie County, Permitting 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 PR®MEN'EDI(U1PR©1IF; LOCA tO�N: Address: 7705 LAKESIDE WAY, FORT PIERCE Legal Description: LAKEWOOD PARK- UNIT 3-BLK 21 LOT 18 Property Tax ID#: 1301-603-0135-000-3 Lot No. Site Plan Name: Block No. Project Name: POLONSKY/REROOF Setbacks Front Back: Right Side: Left Side: mill F III �(@EITIAP�111009.' DESCRlPTI®'[U TEAR OFF SHINGLE, RENAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP METAL PANEL ROOF SYSTEM (FL#17443.1) OVER OWENS CORNING WEATHERLOCK TILE & METAL (FL#9777.7) SELF-ADHERED UNDERLAYMENT. CONSTRUCT Q'N INFORM,A *®W Additional work to a er orme un er t is permit—c ec a appy: OHVAC 0 Gas Tank ❑Gas Piping _Shutters Q Windows/Doors 11 Electric 0 Plumbing Sprinklers Generator Roof 6/12 Roof pitch Total Sq. Ft of Construction: 2,900 S Ft.of First Floor: 1,338 Cost of Construction:$ 11,020 Utilities:Sewer Septic Building Height: 1 STORY OWNER�/L��SSEE: CONS RA.CTL®.R: Name VLADIMIR&IRINA POLONSKY Name: KYLE WHITE Address: 4 PARK DRIVE Company: J.A.TAYLOR ROOFING INC City: LIVINGSTON State: NJ Address: 302 MELTON DRIVE Zip Code: 07039 Fax: City: FORT PIERCE State:FL Phone No.973-768-2573 Zip Code: 34982 Fax: 772-468-8397 E-Mail:V.B.POLONSKY@GMAIL.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. SU'PPLwMEN1'AL CON5TRUCTI©N LIEN LAW INFORMATION: DESIGNER/ENGINEER: t Applicable MORTGAGE COMPANY: LNot Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Applicable BONDING COMPANY: _Not 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 yo property.A Notice of Commencement must be recorded and posted on the jobsite before the first ins tion. If y u intend to obtain financing, consult with lender or an at ney b fore commencin wo r recordiAg your Notice of Commencement. SignatXe of Owner/Lessee/Contractor as Agent for Owner Signature of Contra or/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF STLUCIE COUNTY OF STLUCIE The forgoing instrument was acknowled ed before me The forgoing instrument was acknowledged before me this 12TH day of MARCH Z0�y this 12TH day of MARCH 20ZC7y 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 f Produced ESA to (Signature of Notary Public-.State o ission#GG 3552 (Sig ature of Notary Public- t y Florid 3 _?: * Comm Ovemb8115,2)23 i°` Commission#GG 35520 Commission No. GG 355203 oal xpire sNBu�BVAtrjSe4LOmmisslonNo. GG 355203 * Q Exi �vember15,20 +P23 r BondedThn� r� Sonde d7 eud9o1NoteryServlaee ArFOF f�0 SOF F�� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17