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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ;�
Date: Permit Number: 103" [ O
RFC^ ^I!ED
ow Building Perm itApplication MEN Z�17
Planning and Development Services
Building and Code Regulation Division
N-Nivtf`t`"I'ING
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County,FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof. , m
PROPOSED IIVIPROVEMt T LOCATION:
Address: 133 QUEENS ROAD, FORT PIERCE
Legal Description: QUEENS COVE-UNIT 1 -BLK 18 LOT T
Property Tax ID#: 1414-701-0183-000-2 Lot No.
Site Plan Name: Block No.
Project Name: BECKSTEAD/RE-ROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESC'RIPTION'O`F WORK`
TEAR OFF TILE. RE-NAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP METAL
PANEL ROOF SYSTEM OVER OWENS CORNING WEATHERLOCK TILE & METAL SELF-
ADHERED UNDERLAYMENT. (50 SC!/6/12 PITCH)
,.CONSTRUCTION INFORMATION:Additional workto aperformed under this permit—check
apply:.
HVAC GasTank ❑
EJ
Gas Piping _Shutters Q Windows/Doors
Electric El Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 5000 S . Ft.of First Floor: 2,087
Cost of Construction:$ 17,700 Utilities:Cn Sewer Septic Building Height: 1 STORY
OWNE,R/LESSEE: ; CONTRACTOR:
Name ROBERT&VILMA BECKSTEAD Name: KYLE WHITE
Address: 133 QUEENS RD Company: J.A. TAYLOR ROOFING INC
City: FORT PIERCE State: FL Address: 302 MELTON DR
Zip Code: 34949 Fax: City: FORT PIERCE State:FL
Phone No. 843-270-6066 Zip Code: 34982 Fax: 772-468-8397
E-Mail: 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,LIEN LAW-INFOR'MATIION:
DESIGNER/ENGINEER: x Not Applicable I 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 con.currency 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�orrlgi
perty. A Notice of Commencement must be recorded an posted on the jobsite
before the first ' If you intend to obtain financing, consult with lend attorney before
commenci rrdin our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor Icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCIE COUNTY OF STLUCIE
The rgping instr t was a knowledged before me The forgoing instrument was acknowledged before
l X ��`1��19 f PEd ygr�,�
this day of (` 20aby this day of 20 yl� ��NE MANo, zx
KYLE WHITE KYLE WHITE �SVoae�bar
(Name of person acknowledging) (Name of person acknowledging) �*^ �•® o*
#FF 936050 Q
'9i��4a°�Nofed���°•OQe
(Si nature of Notary Pub ic-State\�� � �'�.�'B9;l (Signature of Notary Publi -State o Flori a) �A,�i;��Op�Ii�ji►o`��\�`�
Personally Known OR lvrodt�c� "l����i ��ior Personally Known x OR Produced Identification
Type of Identification Produce` . ,0er 1S °�m Type of Identification Produced
YP _ Y d ���• e p
Commission No. FF936050 0 a S•� •*e Commission No. FF936050 (Seal)
Revised 07/15/2014 °ae�1C,ST aN�`\�\\\
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE 3 Xci /i
COMPLETE �'
INITIALS 1 1 1