HomeMy WebLinkAboutBUIDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR41,
BY PLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
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APR 19201
Building Permit Application Pffmitting De . partnient
Planning and Development Services St, Lude CDunty
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
�PlRb,
IPOSEPJMPROVEME�NjLoto'
Address: 5408 PALM DRIVE, FORT PIERCE
Legal Description: INDIAN RIVER ESTATES UNIT 08 - EILK 56 LOT 5
Property Tax ID #: 3402-609-0143-000-6 Lot No.
Site Plan Name: Block No.
Project Name: SANTAMARIA/REROOF
Setbacks Front Back: Right Side: Left Side:
TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW OWENS CORNING JA TAYLOR 5V CRIMP
METAL PANEL ROOF SYSTEM OVER OWENS CORNING SELF -ADHERED UNDERLAYMENT.
� e ne M11'is permit —check all apply: ;i o r' R' li 0 13 rto m
1JHVAC Gas Tank Gas Piping In Shutters ❑ Windows/Doors
E]Electric 0 Plumbing F-1 Sprinklers El Generator W1 Roof6/12 Roof pitch
Total Sq. Ft of Construction: 3,600 S Ft of First Floor: 1,710
Cost of Construction:$ 13,310 Utilities: Sewer []Septic Building Height: 1 STORY
&E 7,
-7
CONTRACTOR-"
Name SALVATORE & KATHLEEN SANTA MARIA
Name: KYLE WHITE
Address: 5408 PALM DR
Company: J.A. TAYLOR ROOFING INC
Address: 302 MELTON DRIVE
City: FT PIERCE State: FL
Zip Code: 34982 Fax:
City: FORT PIERCE State: FL
Phone No. 772-206-9969
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
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL
CONST UCTI N
LIEN t AW
INFORMATI0N
DESIGNER/ENGINEER: _
of Applicable
MORTGAGE COMPANY:
1-146't Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
of Applicable
BONDING COMPANY:
t of Applicable
Name:
Name:
Address:
City:
Address:
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 pro erty. A Notice of Commencement must be recorded and don the jobsite
before the first insp ' . If y* intend to obtain financing, consult with lender o for 0 before
commencing wo recordi your Notice of Commencement. ��
Signature of Contractor/License Holder
Signature of Owner/ Lessee/Contractor as Agent,for Owner
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 13TH day of APRIL 20 by
this 13TH 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
Produced
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REVIEWS
FRONT
ZONING
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17