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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
EIV
- ED
Building Permit Application
Planning and Development Services NOV 0 6
Building and Code Regulation Division 2017
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial R Arrrmitt g Depa rpent
PERMIT APPLICATION FOR: Roof
Address: 368 HOSBINE STREET, FORT PIERCE, FL
Legal Description: REPLAT OF PALM GARDENS BLK 8 W 120 FT OF LOT 3 AND ELY 30 FT VAC RD ADJ ON W
Property Tax ID #: 3403-802-0096-000-7
Site Plan Name:
Project Name: WOOLLEY RE -ROOF
Setbacks Front Back:
Right Side: Left Side:
Lot No.3
Block No.
TEAR OFF SHINGE. RE -NAIL DECK. INSTALL NEW JA TAYLOR EDGE LOC 1" METAL ROOF
SYSTEM OVER 30# FELT UNDERLAYMENT. (3 / 12 )
Haamonai wom to pe errormea unaer tnis permit— cnecK ail tnat apply:
OHVAC _ Gas Tank OGas Piping _ Shutters Q Windows/Doors
0 Electric 0 Plumbing Sprinklers Generator R] Roof
Total Sq. Ft of Construction: 3400 S Ft. of First,Floor: 1783
Cost of Construction: $ 12240 UtilitiesliSewer Septic Building Height: 1 STY
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Name b�W d-r-d `li %i- dt /, Wb,, (?::�,
Name: KYLEWHITE
Address: 3�S�in� .S�-
Company: 1A. TAYLOR ROOFING INC
City:State: FL
Address: 302 MELTON DR
Zip Code: 3 Lf q $ 2 Fax:
City: FORT PIERCE State: FL
Phone No. -7Zo1• 370 %y0 i
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
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.
L:AWIN
SIJPPLEMENTAt� CONSTRUCTION LIEN FORIA7ION.
o.
_v
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:
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 your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing,work or recording your Notice of Commencement.
_ �ignatYjre of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF STLUCIE
The for oing instrument was a knowledged before me
this Zday of 20 -aby
KYLE WHITE -1
(Name,6f person acknowledging)
(St ' re of Nofary Publi -'St a of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. GG063270
Revised 07/15/2014
(Seal)
VALERIE J DELGADO
EXPIRES: May 14, 2021
Bonded Thru Budget Notary Services
of Contractor/License H
STATE OF FLORIDA
COUNTY OF STLUCIE
The forgoing instrument wa acknowledged before me
this 2-day of I�dJ�e , 20 0- by
KYLE W ITE
(Nam of person acknowledging)
(S n ture of N tary Pu 1ic- ate of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. GG063270 (Seal)
VALERIE J DELGADO
MY COMMISSION A GG naarm
EXPIRES: May 14, 2021
Bonded Thru Budget Notary SeMces
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