HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 11
Date: Permit Number: 03 Q t&
Building Permit Application MAN 0 6 1
017
Planning and Development Services
Building and Code Regulation Division PERMITTING
i LuceCounty,2300 Virginia Avenue,Fort Pierce FL 34982 St. FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof - Iv\��g1
PROPOSED IMPROVEMENT LOCATION:
Address: 9405 POINCIANA COURT
Legal Description: MEADOWOOD UNIT ONE LOT 24
Property Tax ID#: 1334-503-0026-000-1 Lot No.
Site Plan Name: Block No.
Project Name: HALVORSEN/RE-ROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION QF'WORK. °" '
TEAR OFF TILE. RE—NAIL DECK. INSTALL NEW JA'TAYLOR EDGE—LOC 1"SS METAL PANEL
ROOF SYSTEM OVER OWENS CORNING WEATHERLOCK TILE & METAL UNDERLAYMENT.
(40SQ/5/12 PITCH)
CONSTRUCTION INFORMATION: *a
Additional work to be nertormed under this permit—check all apply:
1_1HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 4,000 S Ft, of First Floor: 3,246
Cost of Construction: $ 19,980.00 Utilities:n Sewer Septic Building Height: 1 STORY
OWNER/LESSEE: „CONTRACTQR:
Name GARY&JUDITH HALVORSEN Name: KYLE WHITE
Address: 12304 DAPHNE DR Company: J.A.TAYLOR ROOFING INC
City: HUNTLEY State:I L Address: 302 MELTON DR
Zip Code: 60142 Fax: City: FORT PIERCE State. FL
Phone No. 847-533-9119 Zip Code: 34982 Fax: 772-468-8397
E-Mail:GTGARY33@COMCAST.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 L 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:
I
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 yo r operty.A Notice of Commencement must be recorded and posted on the jobsite
before the firs a n. If you intend to obtain financing, consult with le r an attorney before
comme ork o ecordin our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signa re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The forgoing instrume t was cknowledged before me The fo going instru en was acl nowledged before me
/
this T day of 20 Q by this day of 20 l�by
KYLE WHITE KYLE WHITE
(Name of person acknowledging) (Name of person acknowledging)
01
�v
gnature of Notary Public-State of Fro gle���)'st7tilltpQ� (Si tu gnare of Notary Public-State of Florida ) �,�peet@�t3sifidtf®te�J`.
�oe\N e p1N E MA AN�/v/� *��'Pp\NG MAnIgFs9 r�/fs
Personally Known x OR Procrdcedo4 ,,'11h90ti*'�`. Personally Known x OR Produced Idefitl�i ltSx�10N�°'°
Type of Identification Produced .Go , Y�. �'� Type of Identification Produced ;U�`'�eer
YP 4 =oPmber 1 0#9 m YP
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Commission No. FF936050 (S IB® CD Commission No. FF936oso (' al)
; #r"r 936050#FF m
v o 936 0V.
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Mary SoN Q0
Revised 07/15/2014 �/s�"I!8 TA EO4 `'��aPd tPlTNl off\\\`\\
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE Al
COMPLETE
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INITIALS