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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION--C ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q Date: SCANNED Permit Number: I Oo'-�c�� roily l�JYI �I��9PI�PS��G�Ye� RECEIVED Building Permit Application APR 12 2018 Planning and Development Services Pef►nitting 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 PERMIT APPLICATION FOR: Roof PROPO$ED.IMPROVEMENT LP AT a Address: 4090 EDWARDS ROAD, FORT PI Legal Description: 29 35 40 W 148.5 FT OF S 880 7 OF W 1/2 OF NW 1/4 OF NW 1/4 - LESS S 33 FT FOR RD Property Tax ID #. 2429-222-0003-000-6 Lot No. Site Plan Name: Block No. Project Name: HINKLE/RE-ROOF Setbacks Front Back: Right Side: Left Side: TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP METAL PANEL ROOF SYSTEM OVER OWENS CORNING SELF -ADHERED UNDERLAYMENT. CONSTRUCTION INFORMATION .� Additionalworkto e e orme under. this permit — check a app y: 11HVAC Ei Gas Tank ❑Gas Piping _ Shutters Windows/Doors 11 Electric ❑ Plumbing Sprinklers Generator Roof 4/12 Roof pitch Total Sq. Ft of Construction: 2,400 S Ft. of First Floor: 1,073 Cost of Construction: $ 10,040 Utilities:Sewer Septic Building Height: 1STORY I OWNER'%LESSEECON1"RACTOR.` ` Name RANDALL HINKLE Name: KYLE WHITE Address: 4090 EDWARDS RD Company: J.A. TAYLOR ROOFING INC City: FORT PIERCE State: FL Address: 302 MELTON DRIVE Zip Code: 34981 Fax: City: FORT PIERCE State: FL Phone No. 772-979-4082 Zip Code: 34982 Fax: 772-468-8397 E-Mail: Phone No. 772-466-4040 E-Mail: NADINE@JATAYLORROOFING.COM Fill in fee simple Title Holder on next page ( if different from the Owner listed above) State or County License: CCC1325895 IIf value of construction is $2500 or more, a RECORDED Notice of Commencement is required. I SUPPLEMENTAL CONSTRUCTIOJV Ip N IA,W fNFURMATI0N DESIGNER/ENGINEER: of Applicable MORTGAGE COMPANY: —L.Ni6t Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: t Applicable BONDING COMPANY: _ of 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 grantingja 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, 11 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 t�recolir)t4g ry. A Notice of Commencement must be recorded and poste he jobsite before the first iyo intend to obtain financing, consult with lender or an ney before commencingwoour Notice of Commencement. I Signature cf Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor icense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF STLUCIE COUNTY OF STLuciE The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 11ih day of APRIL 20_ by this �1th day of APRIL 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 Type of Identification Produced OAl11R@1@!ldJd00 Produced n�511411@@!d!d!!!pA lyWE M,gN9F�roy� a sloN 9 • ��,1SSl0,y 9 Fho•. -her o V� mbar is _ ( ignature of Notary Public- State of Flor )� g= �; N o nature of Notary Pu is -State of Flox{d�;f � v ®.® 11 •#FF FF 936050 Commission No. �Sea`� #FF936050 ;• r No. FF93so5o 936050 9•.a ; �dti`•n �� eon'-dlhto. so ,commission -� '";,'9 a�'ndedlhN. s " off. `� !�`l;lydd@l11111� !ddldl@1111 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED tev. 8/2/17