HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: n Permit Number:
RECEIVED JAN 12 20017
j 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'LOCATIQN `'7 =
Address: 2334 KEEN RD, FORT PIERCE
Legal Description: 31 34 40 FROM SW COR OF NW 1/4 OF NW 1/4 OF SW 1/4 RUN E 330 FT,TH N 258 FT,THE E 125 FT
TO POB,TH CONT E 125 FT,TH N 143.30 FT,TH W 125 FT,TH S 143.30 FT TO POB
Property Tax ID#: 1431-322-001-010-6 Lot No.
Site Plan Name: Block No.
Project Name: HOLLEY/REROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DES PP,�CRIPTION WORK ,i,
TEAR OFF SHINGLES. RE-NAIL DECK. INSTALL NEW 5V CRIMP METAL PANEL ROOF
SYSTEM OVER SELF-ADHERED UNDERLAYMENT. (35 SQ/4/12 PITCH)
CQN�
E . .
STRUCTION`.IN FORMA'TION
Additionalwork to be nprtormed under this permit—check all
app y:
E1HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric Plumbing Sprinklers E Generator W1 Roof
Total Sq. Ft of Construction: 3500 S . Ft. of First Floor: 1611
Cost of Construction:$ 11,900 Utilities:cnSewer Septic Building Height: 1 STORY
01NNER/LE5 �CONTR
SEE .,. � p ACTOR'.
:,..
Name CLAYTON&JULIE HOLLEY Name: KYLE WHITE
Address: 2334 KEEN.RD Company: J.A.TAYLOR ROOFING INC
City: FORT PIERCE State: FL Address: 302 MELTON DR
Zip Code: 34946 Fax: City: FORT PIERCE State:FL
Phone No. 772-454-7238 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: NADINEQJATAYLORROOFING.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.
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
j 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 posted on the jobsite
before the first' c 'on. If you intend to obtain financing, consult with len n attorney before
commencin rk or r cordin our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of ontractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The forgoing instru ent was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 Jaby this-a day of Q �C\ 20 by
KYLE WHITE KYLE WHITE
(Name of person acknowledging) (Name of person acknowledging)
(A nature of Notary Public-State of Florida) (Si ature of Notary Public-State of Florida)
Personally Known x OR Produc,�, ° Personally Known x OR Produced I��y�ljjfj �on
Type of Identification Produced .0� RFg°°i� Type of Identification Produced X�\\\ /r/11.
HIV"-
Commission No. FF936050 ' oS�' O % Commission No. FF996050 as oGp � �QNF�AT•Y
= w tn• e •� oae ly 9Z
Revised 07/15/2014 ��Aq`A `�dedt � � 99 0ndedlhN.
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TL11" M111111 VANG ROVE
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DATE
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