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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 ss Permit Number: 1' (33l
RECEIV-:D APR 19 7017
Building Permit Application
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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,.yh` 9�
PROPOSED,IMP'ROVEME,NT-LOCATION: r
Address: 5401 PALEO PINES CIRCLE, FORT PIERCE
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Legal Description: HOLIDAY PINES S/D- PHASE II - B-LOT 360
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Property Tax ID#: 1312-801-0163-000-0 Lot No.
Site Plan Name: Block No.
Project Name: MONTEROSSO/RE-ROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION'OF'WORK': ;f
TEAR OFF SHINGLES. RE-NAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP
METAL PANEL ROOF SYSTEM OVER OWENS CORNING WEATHERLOCK TILE & METAL SELF
ADHERED UNDERLAYMENT. (34SQ/4/12 PITCH)
CONSTRUCTION INFORMATION i
Additional work to be nprtormed under this permit—check all apply:
11HVAC Gas Tank Gas Piping _Shutters El Windows/Doors
Electric 0 Plumbing Sprinklers ❑Generator W1 RI oof
Total Sq. Ft of Construction: 3,400 S Ft. of First Floor: 2,496
Cost of Construction:$ 12,950 Utilities:Sewer Septic Building Height: 1 STORY
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OWNER/LESSEE: CONTRACTOR:
Name RONALD&SHIRLEY MONTEROSSO Name: KYLE WHITE
Address: 5401 PALEO PINES CIRCLE Company: J.A.TAYLOR ROOFING INC
City: FORT PIERCE State: FL Address: 302 MELTON DR
Zip Code: 34951 Fax: City: FORT PIERCE I State. FL
Phone No. 772-216-0817 Zip Code: 34982 Fax: 772-468-8397
E-Mail: JORON@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.
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SUPPLEMENI'AL,CONSTR'UCTIgN LIEN ILA1N INFwORMATION a :
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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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
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WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to our property. A Notice of Commencement must be recorde and posted on the jobsite
before the f' I ection. you intend to obtain financing, consult��i
a or an attorney before
com work or reco in our Notice of Commencement.
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-rig—nature o ner/Lessee/Agent Sig tyre of Co ractor/License Holder
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STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The forgoing The for oing instrume was ack owledged before me g instru ent was a kno ledged before me
this�day of 20 L,by this 4day of 20 f7by
KYLE WHITE KYLE WHITE
(Name of person acknowledging) (Name of person acknowledging)
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(S' nature of Notary NOW-State of Floric a,F},e�8�l119¢991t/E (Sig ture of Notary Public-State of Florida)
s�v �P1Ef� ,�'rr �®i3E�1861S8d6F8
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Personally Known x OR Produc ii I o f� tG °o �' Personally Known x 1 OR Producegzl*h�ti^c naFST s
Type of Identification Produced � ,w ,g Type of Identification!Produced ° , ,Ne2l"
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Commission No. F936050 T '.(Sea] �.®
F � � Commission No. FF936050
F {Ga OFF 936050 d OFF 936050 '
^�cpdedlhN. se a� Po
�is9�°°atNotary ;°°°c��0e°a
Revised 07/15/2014 ` �s,J�!c.°STAYFoO®i`� ✓,o�(i °°°° of �''
+°s�i11111;4984�
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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