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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ) ' ( ) Permit Number:
-..,, RECEIVE®
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Building Permit Application JAN 13 2017
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: 10960 KIMBERFYLD LN, PORT ST LUCIE
Legal Description: SABAL CREEK- PHASE I -LOT 17
Property Tax ID#: 3321-501-0017-000-5 Lot No.
Site Plan Name: Block No.
Project Name: GUETTLER/REROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED'DESCRIPTION''O'F WORK:
TEAR OFF SHAKE, RE-NAIL DECK. INSTALL NEW JA TAYLOR ROOFING EDGE-LOC 1"SS
METAL PANELS OVER OWENS CORNING WEATHERLOCK TILE & METAL SELF-ADHERED
UNDERLAYMENT. (51SQ /4/12 PITCH)
CONSTRUCTION]N FORMATION:
Additional work to be ertormed under this permit—check all a p p y:
�HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers I Generator Roof
Total Sq. Ft of Construction: 5100 Sq. Ft.of First Floor: 2352
Cost of Construction:$ 27,900 Utilities: Ll Sewer Septic Building Height: 1 STORY
OWNER/LESSEE:, "CONTRACTOR:
Name KARL GUETTLER Name: KYLE WHITE
Address: 10960 KYMBERFYLD LN Company: J.A.TAYLOR ROOFING INC
City: PORT ST LUCIE State: FL Address: 302 MELTON DR
Zip Code: 34986 Fax: City: FORT PIERCE State:FL
Phone No. 772-201-2959 Zip Code: 34982 Fax: 772-468-8397
E-Mail: KGUETTLER@BELLSOUTH.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.
SUPPLEMENTA'CCONSTR'UCT10N b'EN�.LAW INFI'O'WATION'''
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 e . A Notice of Commencement must be recorded and posted on the jobsite
before the first ins you intend to obtain financing, consult with len r an attorney before
commencin or recctding Vour Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature 6f Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The forgoing instrument was acknowl dged before me The forgoing instrument was acknowledged before me
this ,day of tJ 20/by this ,day of 20 LT by
KYLE WHITE KYLE WHITE
(Name of person acknowledging) (Name of person acknowledging)
(Si nature of Notary Public-State of Florida (Si ature of Notary Public-State of Florida)
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Personally Known x OR Produ`c �'fy�atAaap �i� _ Personally Known x OR Produced gr.�(fiLfiat-�`,'�
Type of Identification Produced G �9 Type of Identification Produced
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Commission NO. FF936050 S$al .® •�- FF936050 e� 2p�9�•o
o`,� ) Commission No. _ eal)
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36050
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