HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: 40-0109
BY
u�V i� FEB 0.6 2010
BNM g Pe"'At Application
and Development Permitting Department
Planning P St, Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: Roof
.7 L^+�iYieF r� k t � '� 4 "; � �'dbR . ,� � � ^., w � k" , � i t t '.. Asa
PRC?PO5EDuIMPROVEMENOCATIaN � r" d r 4 ffi, At a
Address: 1605 CODY LANE, FORT PIERCE
Legal Description: COUNTRY LIVING ESTATES S/D BLK B LOT 11
Property Tax ID #: 2305-500-0023-000-4
Site Plan Name:
Project Name: YOUNG/REROOF
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP METAL
PANEL ROOF SYSTEM OVER 30# FELT UNDERLAYMENT (34SQ). FLAT PORTION INSTALL
POLYGLASS MODIFIED BITUMEN SYSTEM W-140 (8SQ).
❑HVAC IJ Gas Tank
❑ Electric 0 Plumbing
Total Sq. Ft of Construction: 4,200
Cost of Construction: $ 15,700
ing u Shutters ❑ Windows/Doors
ars ❑ Generator W1 Roof 5/12 Roof pitch
Sq. Ft. of First Floor: 1,675
Utilities:Sewer []Septic Building Height: 1STORY
O11UIERjLESSEE 5 �.0
n zrcA. k " 1 s4 4' 14"�r'swb %v a ...�,; " ;.. mm.. .k.�. „r.,^u �_
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Name MARISSA YOUNG
Name: KYLE WHITE
Address: 1681 SW BUFFUM LN
Company: J.A. TAYLOR ROOFING INC
City: PORT ST LUCIE State: FL
Address: 302 MELT DRIVE
Zip Code: 34984 Fax:
City: FORT PIERCE State: FL
Phone No. 561-729-6160
Zip Code: 34982 Fax: 772-468-8397
E-Mail: MARAE23QGMAIL.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: CCC1325895
IT value oT construction is tiZSoo or more, a RECVRDED Notice of Commencement is required.
SUPPL�EMEN_ TAL CON�STRl1CTIONLIEN�IA1I1/MIUFORtVIATICIN
DESIGNER/ENGINEER:
_Not Applicable
MORTGAGE COMPANY:
Applicable
Name:
Name:
_Not
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 inspgxA4ion. If ou intend to obtain financing, consult with le er an attorney before
commenci or recor ing your Notice of Commencement.
Signature of Contractor/License Holder
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORID
STATE OF FLORIDA
COUNTY OF a��UC.-C
COUNTY OF _CALL)O_l-e—
The for oing instrument was acknowledged before me
The forg ing instr rent Was
acknowledged] before me
this day of cv0.c 20ja by
this day of
U , 20 by
KYLE WHITE
KYLE WHITE
Name of person king statement
Name of person rpaking statement
Personally Known _ OR Produced Identification
Personally Known V
R Produced Identification
Type of Identification
`
Type of Identification
`11611i1lIOOOi
Produced
RFSg`X.,
Produced
Mdrid.
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(Si nature of Notary Public- State ag_F*lo�i�°�
of Notary Public- State of Flo & m°o :
F 936050 ; mac`
Commission No. FF936050 may° Se y•m �Oe
Commission NO. FF936050
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REV
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
2'00? ��8
Rev. 8/2/17