HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED p
Date: Permit Number:
s RECEIVED
Build in"JWFAA`pplication APR 12 nie
Planning and Development Services Permitting Department
Building and Code Regulation Division
St. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XX
r
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 5405 SHANNON DRIVE, FORT PIERCE
Legal Description: LAKEWOOD PARK - UNIT 12 - BLK 159 LOT 6
Property Tax ID #: 1301-614-0066-000-2 Lot No.
Site Plan Name: Block No.
Project Name: SCOTT/RE-ROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION DESCRIPTION OF WORK: '° u
TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP METAL
PANEL ROOF SYSTEM OVER OWEN&CORNING WEATHERLOCK TILE & METAL SELF -
ADHERED UNDERLAYMENT.
CONSTRUCTION INFORMATION:
Additional work to be nertormed under t is ,permit —check all apply:
11HVAC Gas Tank E]Gas Piping _ Shutters ❑ Windows/Doors
❑ Electric ❑ Plumbing Sprinklers Generator W1 Roof 5/12 Roof pitch
Total Sq. Ft of Construction: 2,200 S Ft. of First Floor: 1,261
Cost of Construction: $ 8,300 Utilities:n Sewer Septic Building Height: 1 STORY
OWNER/LESSEE �
CONTRACTOR:
Name SEAN SCOTT
Name: KYLE WHITE
Address: 5405 SHANNON DR
City: FT PIERCE State: FL
Zip Code: 34951 Fax:
Phone No. 772-971-6966
E-Mail:
Fill in fee simple Title Holder on next;page ( if different
from the Owner listed above)
Company: J.A. TAYLOR ROOFING INC
Address: 302 MELTON DRIVE
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: CCC1325895
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN .LAW INFORMATIO"N:p
DESIGNER/ENGINEER: ✓Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: 4/Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: "ot Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: VNot Applicable
Name:
Address:
City:
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 they 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 Commeincement must be recorded an osted on the jobsite
before the first inspectio d to obtain financing, consult with lend r att ney before
commencing work In Notice of Commencement.
I
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OF STLUCIE
The forgoing instrument was acknowledged before me I
The forgoing instrument was acknowledged before me
this 11th day of APRIL 20_ by
I
this 111h day of APRIL 20_ by
I
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
l411!! I Il!!P
Type of Identification
Produced
Produced
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DATE
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DATE
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Rev. 8/2/17