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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Permit Number:
RECEN7:0 AN 19 2�17
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof —
PROPOSED IMPROVEMENT LOCATION:
Address: 5877 CLYDESDALE LANE, FORT PIERCE
Legal Description: PONY PINES- UNIT ONE BLK A LOT 4
Property Tax ID#: 3309-605-0007-000-3 Lot No.4
Site Plan Name: Block No. A
Project Name: WHIDDEN/REROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
TEAR OFF SHINGLE. RE-NAIL DECK. INSTALL NEW JA TAYLOR ROOFING EDGE-LOC 1"SS
METAL PANEL ROOF SYSTEM OVER OWENS CORNING WEATHERLOCK TILE & METAL
UNDERLAYMENT. (41 SQ/5/12 PITCH) REPLACE TWO 2'X2' GLASS IMPACT SKYLIGHTS.;
CONSTRUCTION INFORMATION:
Additional work to be e ormen p under this permit—check all apply:
11HVAC Gas Tank Gas Piping fn Shutters Windows/Doors
Electric ❑ Plumbing OSprinklers In Generator Roof
Total Sq. Ft of Construction:' 4100 S .L. of First Floor: 2178
Cost of Construction: $ 18,500 Utilities: Sewer E]Septic Building Height: 1 STORY
OWNER/LESSEE: CONTRACTOR:
Name MICHAEL&KATHERINE WHIDDEN Name: KYLE WHITE
Address: 5877'CLYDESDALE LN Company: J.A.TAYLOR ROOFING INC
City: FORT PIERCE State: FL Address: 302 MELTON DR
Zip Code: 34987 Fax: City: FORT PIERCE State: FL
Phone No. 772-595-9060 Zip Code: 34982 Fax: 772-468-8397
E-Mail: MICHAEL_WHIDDENQATT.NET 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: CCC 1325895
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION-LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 inspe qI)on. If you intend to obtain financing, consult with le or an attorney before
commencing wor_ki6ffec9j+di-ng your Notice of Commencement.
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_Signat e of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCIE COUNTY OF STLUCIE
The fo ng instrum nt was acknow edged before me The forgoing instrument was acknowledged before me
this day of U 2017by this day of 20 by
KYLE WHITE KYLE WHITE
(Name of person acknowledging) (Name of person acknowledging)
.avc� I
(Si ature of Notary Public-State of Florida) Ignature of Notary P blic-State of Ion Ili►l,41,11,�'
x a 4 4B 'A x v �Ns M�RFsq''�rs'.
Personally Known OR Produced Iddia � ff�,e�" Personally Known OR Prod-edOt)�8�ip d�
Type of Identification Produced ��° .��,°.•®. �9Fo°d,: Type of Identification Produced
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FF 936050 _� bBr 1 s �i: FF 936050 °
Commission No. {Star 2 q , Commission No. _*; (Snt ;
* `_ o� u . — #FF 936050 o Nc
° e se f •` e y Q °�
Revised 07/15/2014 0099�� eNo N s•�oQ�\� s�`�e�°'94/ti TP, \o��\\
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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