HomeMy WebLinkAboutBuilding Permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Num
ED
_ _ �.
NCU 6 2017
Building Permit Applicatio
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie Count
2300 Virginia Avenue, Fort Pierce FL 34982 �r FL,
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PRCjPOSED°IIVIPR01/EME'NT LOCATION,
Address: 9421 POINCIANA COURT, FORT PIERCE, FL
Legal Description: MEADOWOOD UNIT ONE LOT 32
Property Tax ID #: 1334-503-0034-000-0 Lot No.32
Site Plan Name: Block No.
Project Name: KOLOSOWKY RE -ROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED E DSCRIP
TION ,'OF WORK
'§9u"v14'3
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TEAR OFF TILE ROOF. RE -NAIL DECK. INSTALL NEW JA TAYLOR 1" EDGE LOK METAL
ROOF SYSTEM OVER _30# FELT UNDERLAYMENT (6/12 )
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it k � M 6
CONSTRUCT1 NIN`EORIVIATION
Additional work to be nertormed under this permit —check all apply:
11HVAC Gas Tank ❑Gas Piping _ Shutters Windows/Doors
11 Electric ElPlumbing Sprinklers FIGenerator Roof
Total Sq. Ft of Construction: 4100 S . Ft. of First Floor: 1729
E]
Cost of Construction: $ 18900 Utilities:i Sewer Septic Building Height: 1 STY
OWNER/LESSEE n
CONTRACTOR r17
,
Name! �q� KC) ( 05; > V✓ S
Name: KYLE WHITE
Company: J.A. TAYLOR ROOFING INC
Address: / -10�- f 6-iCca ncL C4--
City: 4— —P State: FL
�i2
302 MELTON DR
Zip Code: 34982 Fax:
City: FORT PIERCE State: FL
Phone No.772.466.4040
Zip Code: 34982 Fax: 772-468-8397
E-Mail: NADINE@JATAYLORROOFING.COM
Phone No. 772-466-4040
Fill in fee simple Title Holder on next page ( if different
E-Mail: NADINE@JATAYLORROOFING.COM
State or County License: CCC 1325895
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW (NF.ORMATION`
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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:
City:
Address:
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 thee,i�first inspection. If you intend to obtain financing, consult with lender or an attorney before
c4nmencft work or recording your Notice of Commencemgnt. 1,
_ Siggtbre bf Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF STLUCIE
The foZ-oing instr endwas cknowledged before me
this dayof 20 ,Ja-by
KYLE WHITE -L
Contractor/License Holder
STATE OF FLORIDA
COUNTY OF STLUCIE
The for oing instrument /w,asa knowledged before me
this 7dayof�(,�(/�`�.20 12-6y—
KYLE WHITE
person acknowledging) I (Namyof person a
re f Nota -State of Florida) I (S,_,►' nature of lytary P ic- State of Florida )
Personally Known OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. GG0e3270 r($e�kFRIEJDELGADO Commission No. 00063270 (Seal)
�' 'pu� VALERIE J DELGADO
MY COMMISSION # GG 0600
N� `fie CArinW. may .-., ---_--.. -_ ---
Revised 07/ 15/2014 AfCOF F�°� Bonded Thru Budget Notary Services EXPIRES: May 14, 2021
9rFOF Fly"\ Bonded Thru Budget NotarySeM=
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