HomeMy WebLinkAboutBuilding Permit Application ALL APPLI A LE INF M TE-COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
•1
!I: Building Permit Application
Planning and DevelopmentSeMces'
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,
-PROPOS.ED IMPROVEMENT LOCATION: ;
Address: I 1661 MALLARD COURT; FORT PIERCE
Legal Description:' NORTH FORK ESTATES S/D LOTS 18,19 AND 20
Property Tax ID#: 3409-503-0021-000-1 Lot No.
Site Plan Name: Block No.
Project Name: I SINYARD/REROOF
Setbacks Front Back: Right Side: Left:Side:
DETAILED DESCRIPTION OF WORK
TEAR OFF FLAT'PORTION OF ROOF ONLY. RE-NAIL DECK. INSTALL NEW POLYGLASS
3-PLY FLAT ROOF SYSTEM. (12 SQ)
CONSTRUCTION INFORMATION:
Additional workto,be e orm e under this permit—check a apply:
❑HVAC E]GasTank ❑Gas Piping Shutter
s ❑Windows/Doors
Electric ❑ Plumbing Sprinklers MGenerator Roof
Total Sq. Ft of Construction: 1,200 S Ft. of First Floor: 2,709
Cost of Construction:$ 5,900 Utilities:Sewer Septic Building Height: 1 STORY
OWNER/LESS,EE: ` ,, CONTRACTOR:
Name VIRGINIA TENNYSON&ANTHONY SINYARD Name: KYLE WHITE
Address: 1661 MALLARD CT Company: J.A.TAYLOR ROOFING INC
City: FT PIERCE State: FL Address: 302 MELTON DR
Zip Code: 34982 Fax: City: FORT PIERCE State:FL
Phone No.404-787-6525 Zip Code: 34982 Fax: 772-468-8397
E-Mail: AANSINYARDQGMAIL.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.
r I
SUPPLEMENTAL:CONSTR.UCTI,ON LIENLAW'INFORIVIATION '
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: I 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 i ection. If you intend to obtain financing, consult with le er or an attorney before
commencing,viMipr recording our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent,, Signa ure o Contractor/License Holder
STATE OF FLORIDA` STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The for ing instrument w ackn wledged before me The foing iinstrum t w sack owledged before me
this Jday of G( 20 1 7-by this day of- 20 by
KYLE WHITE KYLE WHITE
(Name of person acknowledging) (Name of person acknowledging)
(S' nature of Notary Public-State of Florida) (Sign ure o Notary Public-State of Flon
`o`�t;9311{i11fPf/I`j �\���.GiHHtilPldlfl����
Personally Known x OR Prod IQf {i Personally Known x OR Produced �c}VeWl
Type of Identification Produced ,*v S_I0N• ��i _ Type of Identification Produced ,` .�t��SSION��• ';
' � :o� Mbar 1S,20 9�: � •o�'�c�`o'e 3'20�9�,�=
Commission No. FF935050 eal) cn *_ Commission No. FF936050
"� 936050 :Q� = OFF 936050 ::o`
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Revised07/15/2014 LIc sTp���� ''9i��e
111
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
CO M P LETE
INITIALS ! '' !
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