HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:7. 2 2 f�— Permit Number:
W IVED
Building Permit Application
Planning and Development Services FEB 2 2 2017
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 PERMITTING
Phone: (772)462-1553 Fax: (772)462-1578 Commercial ResidenttiLq�cie County, FL
PERMIT APPLICATION FOR: Roof
.PROPOSED IMPROVEMENT LOCATION:
Address: 8208 PASO ROBLES BLVD, FORT PIERCE
Legal Description: LAKEWOOD PARK- UNIT 8 BLK 91 LOT 10
Property Tax ID#: 1301-608-0085-000-2 Lot No.
Site Plan Name: Block No.
Project Name: JOHNSON/RE-ROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION°OF WORK:, .t
TEAR OFF SHINGLE AND FLAT SECTION, RE-NAIL DECK. INSTALL NEW OWENS CORNING
OAKRIDGE SHINGLE ROOF SYSTEM OVER 30# FELT UNDERLAYMENT. (26SQ /4/12 PITCH)
INSTALL POLYGLASS MODIFIED BITUMEN ROOF SYSTEM ON FLAT PORTION (4SQ)
CONSTRUCTION INFORMATION.`
Additional
❑IHVAC or to e ertormed Gas Tank under this permiGas Pit in checka app y:
_Shutters Windows Doors
11 ❑ Piping ❑ /
Electric ❑ Plumbing Sprinklers I Generator W1 Roof
Total Sq. Ft of Construction: 3000 Sq. Ft. of First Floor: 2244
8,750 1 STORY
Cost of Construction: $ Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name CORY&JENNIFER JOHNSON Name: KYLE WHITE
Address: 8208 PASO ROBLES BLVD 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. 772-215-4002 Zip Code: 34982 Fax: 772-468-8397
E-Mail: TUSCANYBAYHOMESI @GMAIL.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.
I ,
SUPPLEMENTAL CONSTRUCTION,LIEiN L'AW'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 ' pec ' n. If you intend to obtain financing, consult with I r an attorney before
commencin rk orfE/cording your Notice of Commencement.
s
SigKature of Owner/ essee/Agent SignaturEFof Contractor/License Holder
STATE OF FLORIDA STATE OF FLOR16A
COUNTY OF ST LUCIE COUNTY OF STLUCIE
The forgoing instrument as acknowiedged before me The forgoing instrument was acknowledged before me
this_L—J day of 20 L7by this day of 20 by
KYLE WHITE KYLE WHITE
(Name of person acknowledging) (Name of person acknowledging)
( gnature of Notary P blic-State of Florida) (Signat re of Notary Public-State of Florida)
*s�y,tll4eul1311'�,J6,, 4 ea!l11111?t't, ,�.,
Personally Known x OR Prodj,68" 'l�d 1 II io f _ Personally Known x OR Produce&TdRn1 #rc� I fq'._
Type of Identification Produced ��";'t�SSION"°°• Type of Identification Produced ' r'
a 4 O�bZ—T�9° c
Commission No. FF936050 °z (Sea1) �v��"' u Commission No. FF936050 ® o eal)�gA9tn'o
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DATE
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