HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `\a`�1 Permit Number: 11 d 1" d'a�rc
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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 -
PRO1POSED IMPROVEMENT'LOCATION
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Address: 2175 JOHNSTON RD, FORT PIERCE
Legal Description: 34 34 39 N 1/2 OF N 1/2 OF SW 1/4 OF SE 1/4-LESS E 40 FT AND LESS THE S 60 FT OF W 341 FT
OF E 381 FT
Property Tax ID#: 1334-431-0001-000-0 Lot No.
Site Plan Name: Block No.
, Project Name: TEDDER/REROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OkFTM11VORK ?x` ``C1 k d ` '
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. (41 SQ/512 & 3/12 PITCH)
CONSI"RUCTION INFORIVIMATIQN
Additional work to e nertormed under this permit—c ec k a app y:
11HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 4100 S Ft.of First Floor: 1853
Cost of Construction:$ 16,755 Utilities: Sewer E]Septic Building Height: 1 STORY
OWNER/LESSEE
>a CONTRACTOR.
Name ROBERT&JESSICA TEDDER Name: KYLE WHITE
Address: 2175 JOHNSTON RD Company: J.A.TAYLOR ROOFING INC
City: FORT PIERCE State: FL Address: 302 MELTON DR
Zip Code: 34951 Fax: City: FORT PIERCE State:FL
Phone No. 772-216-0318 Zip Code: 34982 Fax: 772-468-8397
E-Mail: JUSTIN.TEDDER82@YAHOO.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: CCC 1325895
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIENLAW INFORMATIOkN
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 fie(
r property.A Notice of Commencement must be recorded and posted on the jobsite
before the fir tion. If you intend to obtain financing, consu le der or an attorney before
commenci recordingour Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The f oing instrum nt was acknowledged before me The for oing instrument was acknowledged before me
this'L day of 20 (lby this 7 day of (Z,(�U � 20 L-1 by
KYLE WHITE KYLE WHITE
(Name of person acknowledging) (Name of person acknowledging)
(S' nature of Notary Public-State'of Florida) (Si ature of Notary P blic-State of Florida
Personally Known x OR Produced Id 1i4i,�pl n Personally Known x OR Produced Id tion
Type of Identification Produced_ ore �NF MA A.�'X, Type of Identification Produced ve� �P.AAA, o
o, 0 � e\ ,.... F r,
\0a 11SSi0 °•9 �i� °1.,
Commission No. FF936050 L, er 1 e SF�° o Commission No. FF936050 SF 9
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y #FF 936050 = ° 9FF 936050 °
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DATE
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