HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONT
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t /�
Date.Z& - I p Permit Number:
SCANNED
BY
SM Lueip r.01161
Building Permit Application
Planning and Development Services I
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL134982
Phone: (772) 462-1553 Fax: (7712) 462-1578 Commercial
PERMIT APPLICATION FOR: Roof
M' %YF
Residential xx
PROPOSED IMPROVEMENT LOCATION
Address: 3605 S INDIAN RIVER DRIVE, FORT PIERCE (DETACHED GARAGE)
I
Legal Description: 26 35 40 S 157 FT OF N 877.5 FT OF NE 1/4 OF SW 114 AND S 157 FT OF N 877.5 FT OF GOV
LOT 4 - LESS N 70 FT OF E 349 FT
Property Tax ID #. 2426-313-0001-000-2 Lot No.
Site Plan Name: I Block No.
Project Name: WILKES-GARAGE/REROOF
Setbacks Front I Back: Right Side: Left Side:
DETAILED DESCRIPTION OFWORIC
TEAR OFF TAR & GRAVEL, RE -NAIL DECK. INSTALL 3-PLY POLYGLASS MODIFIED FLAT
ROOF SYSTEM. 1
'teGSA"E.
Additional worl(to be errormed under this permit —check all apply:
EIHVAC _Gas Tank Gas Piping _ Shutters
Electric ❑ Plumbing Sprinklers ❑ Generator
Total Sq. Ft of Construction: 1,000
Cost of Construction: $ 61,800
S Ft. of First Floor: 672
Utilities:cn Sewer []Septic
❑ Windows/Doors
W1Roof Roof pitch
Building Height: 1 STORY
$OWNER/LESSEEx`>CONTRACTOR'
�. .
Name NASREEN WILKES
Name: KYLE WHITE
Address: 3605 S INDIAN RIVER DR
Company: J.A. TAYLOR ROOFING INC
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Code: 34982 Fax:
City: FORT PIERCE State: FL
Phone No. 772-828-1255
Zip Code: 34982 Fax: 772-468-8397
E-Mail: NMKWCAW@GMAIL.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: CCC1325895
from the Owner listed above)
it value of construction is $ZSoo or more, a RECORDED Notice of Commencement is required.
SUPPLEM}ENT�AL,CONSTRjU�TION�LIEN �r WNFORIVIA�TIOIV�:
� � �
DESIGNER/ENGINEER: _INot Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address: I
Address:
City: I State:
City:
State:
Zip: Phone I
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY:
Not Applicable
Name: I
Name:
Address: I
Address:
City: I
City:
Zip: Phone:
Zip: Phone: I
I
OWNER/ CONTRACTOR AFFIDVITP: 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 representatioln 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, Ithe Florida Building Codes and St. Lucie County Amendments.
The following building permit applicatigns 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.lA Notice of Commencement must be recorded and posted on the jobsite
before the first in on. If you intend to obtain financing, consult with lender or for ey before
commencin r recociing your Notice of Commencement. /7
I
Signature of -Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OF STLUCIE
The forgoing instrument was ackn I ledged before me
The forgoing instrument was acknowledged before me
this 19 day of MARCH .20_ by
this 19 day of MARCH 20_ by
KYLE WHITE
KYLE WHITE
Name of person making statement
Name of person making statement
Personally Known xx OR Produced Identification
Personally Known xx OR Produced Identification
Type of Identification �\a`,�`��i0otiB09illoaea°®°
Type of Identification
Produced �� p�NEM1WRe pie/
Produced �a�6l18119101/��'��°
S31oN �•, ,,
a� p,D1NE M,q/y °°,o
•IS$ 9FCPE°"d
e o°vo�bor 1sF °i • %
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ber le
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(Signature of Notary Pub ic- State q Floridai)FF 936050 m
(Signature of No ry Pu ic- State of Flpr ®.Cn
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/•°° 6 6onded�ht�.o: oQ�
Commission N0. FF936050 �sr9 �� Notary$eN•° k� s�
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Commi55ion NO. FF936050 d9 "°�.I,� g050
s�°'°PpUBUC, STA�EO\q�RN
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17