HomeMy WebLinkAboutBuilding Permit Application � 1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11'a� ,� Permit Number: V1 t �da
RECEIVED JAN 12 70117
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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
5'PROPOSED IMPROV0*NT:LOCATIQN,
;Address: 10751 S OCEAN DR LOTA8,JENSEN BEACH
Legal Description: 11 37 41 FROM SW COR SEC 12-37-41 RUN 89 DEG 55 MIN 14 SEC E ALG S SEC Li 774.41 FT TO C/L AIA
TH N 23 DEG 49 MIN 31 SEC W ALG SD C/L 2921.33 FT,TH S66 DEG 10 MIN 29 SEC W 290.01 FT,TH N 87 AND MORE
Property Tax ID#: 4511-311-0012-000-3 Lot No.
,Site Plan Name: Block No.
Project Name: MOSER/REROOF
Setbacks Front Back: Right Side: Left Side:
DETA ILED D ESCRIPTION OF;WORKS 3 ,`r h: °° 'rt ; u"
TEAR OFF SHINGLE. RE-NAIL DECK. INSTALL NEW EDGE-LOC 1"SS METAL PANEL ROOF
SYSTEM OVER OWENS CORNING WEATHERLOCK TILE & METAL SELF-ADHERING
UNDERLAYMENT. (28SQ/6/12 PITCH)
CONSTRUCTION FORM,TION. ,
..
Additional work to be performed under this permit—check all apply:
OHVAC Gas Tank Gas Piping OGenerator
Shutters ❑Windows/Doors
11 Electric Plumbing Sprinklers W1 Roof
Total Sq. Ft of Construction: 2800 S Ft.of First Floor: 1,642
Cost of Construction:$ 16,600 UtilitiesInSewer Septic Building Height: 2 STORY
OWNER/LESSEE , COaNTRACTOR r
A . . ..
Name THOMAS&WENDY MOSER Name: KYLE WHITE
Address: 10751 S OCEAN DR, LOT AB Company: J.A.TAYLOR ROOFING INC
City: JENSEN BEACH State: FL Address: 302 MELTON DR
Zip Code: 34957 Fax: City: FORT PIERCE State:FL
Phone No. 772-485-2076 Zip Code: 34982 Fax: 772-468-8397
E-Mail:TOM@CASHSERVICESTC.COM Phone No. 772-466-4040
Fill in fee simple Title Holder on next page(if different E-Mail: NADINE@JATAYLORROOFINO.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 y
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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 recor ed and posted on the jobsite
before the first ins 'on. If you intend to obtain financing, consult wi e r or an attorney before
commencing recording our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contrac or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
'COUNTY O.F STLUCIE COUNTY OF STLUCIE
The f oing instrument was acknow)edgecLbefore me The f oing instrum nt was acknowl dged before me
this day of 201 _by this�day of L9 20 by
KYLE WHITE KYLE WHITE
(Name of person acknowledging) (Name of person acknowledging)
.02L,�
(S gnature of Notary Public-State of Florida) (S-iffrairre of Notary Public-State of Florida)
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Personally Known x OR Pro la4l(r�b® Personally Known x OR Produced.(
'Type of Identification Produced >�° 9 % Type of Identification Produced
e�ber 150� y d ° S�oi9�
Commission No. FFsssoso •gz(Seal) N m z Commission No. FFs3soso o �I) m a*
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