HomeMy WebLinkAboutBUILDING PERMIT APPLICATION1
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: S Permit Number: `1 d5 -O 5S1
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RECEIVSQ MAY 2 5 2017
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Building Permit Application
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
PROPOSED IMPROVEMENT LOCATION'
Address: 1918 N 50TH STREET, FORT PIERCE
Legal Description: HARMONY HEIGHTS BLK F LOTS 16 AND 17
Property Tax ID #: 2406-502-0106-000-6
Site Plan Name:
Project Name: REGINA/REROOF
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:`
TEAR OFF TEAR OFF FLAT ROOF. RE -NAIL DECK. INSTALL NEW POLYGLASS MODIFIED
BITUMEN ROOF SYSTEM. (19 SQ / 1 1/2 /12 PITCH )
CONSTRUCTION INFORM'ATIO'N
Additionalworkto a performed
under this permit— check
a
apply:
E,HVAC
Gas Tank
❑Gas Piping
_Shutters
Q Windows/Doors
11 Electric 0 Plumbing
Sprinklers
Generator
W1 Roof
Total Sq. Ft of Construction: 1,900
S Ft. of First Floor: 1,110
Cost of Construction: $ 7,800
Utilities:'nSewer
Septic
Building Height: 1 STORY
OWNER/LESSEE:",, p.:CONTRACTOR:
Name REGINA PATTERSON-ANDERSON
Name: KYLE WHITE
Address: 1918 N 50TH STREET
Company: J.A. TAYLOR ROOFING INC
City: FORT PIERCE State: FL
Zip Code: 34947 Fax:
Phone No.
E-Mail: HANCEJ@STLUCIECO.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Address: 302 MELTON DR
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4040
E-Mail: NADINE@JATAYLORROOFING.COM
State or County License: CCC 1325895
IT value or construction is >zSuu or more, a KtcUKDtD Notice of commencement is required.
SUPPLEMENTAL CONSTRUCTILIEN ON LAW INFORMATION:
�.F
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-oT-,dcording vour Notice of Commencement. e
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF STLUCIE
The forgoing instru en was a knowledged before me
this oaday of 20 C-by
ctor/License Hol
STATE OF FLORIDA
COUNTY OF STLUCIE
The forgoing instrument w s acknowledge—d- �before me
this day of 20 1 by
KYLE WHITE KYLE WHITE
(Name of person acknowledging) (Name of person acknowledging )
of Notary Public- State of Florida
Personally Known x OR Produced
Type of Identification Produced
Commission No. FF936050
#FF 936050
(Sigdature of Notary Public- tate of Florida )
�V' �,gti1��I110o100Pg�'
sonall Known x OR Produc Qp�ffiP 1*11.
.� y �°°,!�, r
Ty*e of Identification Produced°° 1SRIpp�grro
DCOEnmisslonNo. FF936050 q ®goal) 2o�9Nm
®°SAU9C1C, STA1EQj, Nam` y 9 a�0ndedlbN.\�o; �Q�I�
Revised 07/15/2014 py+'s'yr�;colia�o���'+�\ %�9�A ° 1N°tarySe�,. ��oz
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