HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ^^ //'��
Date: Permit Number: � 01- 0043
0 ENO"m
Building Permit Application
Planning and Development Services ®EC 0
Building and Code Regulation Division®�%
2300 Virginia Avenue, Fort Pierce FL 34982 a t,?{{gInIMG
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential "k Lucle Coup, FL
PERMIT APPLICATION FOR: Roof
Address: 9864 OKEECHOBEE ROAD, FORT PIERCE (HOUSE)
Legal Description: WALSH FARMS FROM SW COR OF TRACT 2 RUN NELY ON OKEE RD 165 FT, TH NWLY 1160.5 FT
M/L TO N LITRACT 2, TH RUN W ON N LI 212.5 FT TO NW COR OF TRACT 2, TH SELY 1218 FT M/L POB-LESS RD R/W
Property Tax ID #:
Site Plan Name:
Project Name: _
Setbacks Front
DETAILED DES
2327-601-0003-000-6
GAGNON/REROOF
Back: Right Side: Left Side:
Lot No.
Block No.
TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL JA TAYLOR ROOFING EDGE-LOC METAL
PANEL ROOF SYSTEM OVER SELF -ADHERED UNDERLAYMENT (3/12 PITCH / 28SQ).
FLAT PORTION (3SQ) INSTALL POLYGLASS MODIFIED BITUMEN ROOF SYSTEM (W-138)
CONSTRUGTibN' F INFORMATION
. , .
Additional work to be nertormed un er t is permit- check all fnapply:
E1HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers E Generator W1 Roof
Total Sq. Ft of Construction: 3,100 S Ft. of First Floor: 1,944
Cost of Construction: $ 14,660 UtilitieslnSewer Septic Building Height: 1 STORY
OWNER/LESSEE:
CO.NTRACTO:R:
Name JUANITA GAGNON
Name: KYLE WHITE
Address: 9864 OKEECHOBEE RD
Company: J.A. TAYLOR ROOFING INC
City: FT PIERCE State: FL
Address: 302 MELTON DR
Zip Code: 34945 Fax:
City: FORT PIERCE State: FL
Phone No. 772-359-4124
Zip Code: 34982 Fax: 772-468-8397
E-Mail: SIMMONSPROCESSSERVICE®GMAIL.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
VQuc Lwn IULAIWn 15 g43VV or more, a KcwKuru Notice OT GOmmencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
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:
Name:
Address:
City:
Zip: Phone: _
x Not Applicable
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
x Not Applicable
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 OWN : Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to ueflo
erty. A Notice of Commencement must be recorde nd posted on the jobsite
before the nspef you intend to obtain financing, consult with I own attorney before
com cl work ording your Notice of Commencement.
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF STLUCIE
The forgoing instrumel t was acknowledge fore me
this � day of 20 L�y
KYLE WHITE
(Name of person acknowledging)
ature of Notary Public- State of Flo
Personally Known x OR Prod
Type of Identification Produced_
--c
Commission No. FF936050 �* o (Seal)"'
n #FF 936050
2wim
Revised 07/15/2014
ctor/License Holder
STATE OF FLORIDA
COUNTY OF STLUCIE
The forgoing instrumen was acknowledge "fore me
this � day of 20 � by
KYLE WHITE
(Name of person acknowledging)
(Sign ure of Notary Public- State of Florida
.0 llllllllifa..
Personally Known x OR Prod
Type of Identification Produced_
Commission No. FF936050 Lo N;
z : 4FF a iF
936050
fay...
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
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REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS