HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INF(O� MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r
Date:' I �' ( d Permit Number:
1
OWNED
iL1 RECEIVED
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Building Permit Application MAY 112018
Planning and Development Services
Building and Code Regulation Division ' ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982 I!
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XX
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PERMIT APPLICATION FOR: Roof
PROPOSED fMPR4VEMENT LOCATION:
Address: 5909 GREEN DOLPHIN STREET, FORT PIERCE
Legal Description: LAKEWOOD PARK - UNIT 5 - BLK 43 LOTS 13 & 14
Property Tax ID #: 1301-605-008400-6 Lot No.
Site Plan Name: / Block No.
Project Name: KAYLOR / REROOF
Setbacks Front lBack: Right Side: Left Side:
DETAILED DEASCRI,PTION OF WORK:
TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP METAL
PANEL ROOF SYSTEM/OVER OWENS CORNING WEATHERLOCK TILE & METAL SELF -
ADHERED UNDERLA YMENT.
CONST UCT(ON INFOR� ATION:
Additional work to je pe orme a under this permit — c ec app y:
11HVAC LJ Gas Tank ❑Gas Piping —.Shutters []Windows/Doors
Electric ❑l Plumbing Sprinklers ElGenerator W1 Roof 4/12 Roof pitch
Total Sq. Ft of Constr /Ition: 2,500 S . Ft. of First Floor: 1,231
Cost of Construction:,$ 9,450 Utilities:nSewer Septic Building Height: 1 STORY
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Name CHRISTINE
Address: 5909 GI
City: FT PIERCE
Zip Code: 34951/
Phone No. 772-4E
E-Mail: JINGLE6�
)H Name: KYLE WHITE
DOLPHIN ST Company: J.A. TAYLOR ROOFING INC
State: FL Address: 302 MELTON DRIVE
Fax:
ATT. N ET
i
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4040
E-Mail: NADINE@JA--AY_oRR00FjNG.COM
State or County License: CCC1325895
If value of cor struction is $2500 or more, a RECORDED Notice of Commencement is required.
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SJUPPLEM'ENTAL C4NSTR+UCTION LDEN LAW Ii=0 MATION:
DESIGNER/ENGINEER: L/Not Applicable
Name:
MORTGAGE COMPANY: _ of Applicable
Name:
Address: I
City: State:)
Zip: Phone I
I
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable
Name:
Address: I
BONDING COMPANY: _ of Applicable
Name:
Address:
City: I
Zip: Phone: I
• I
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 the issuance of a permit.
St. Lucie County makes no representation that is grantingla 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, Ildo 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 No -
improvements to ur property. A Notice of Coml
before the first ' ecVC1
n. If you intend to obtain
commencin k or rding your Notice of Coi
:e of Commencement may result in your paying twice for
encement must be recorded and posted on the jobsite
financing, consult with lender or, attorney before
mencement. �
I
Ignature 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 acknowledged before me
The forgoing instrument was acknowledged before me
this 10TH day of MAY 20_ by
this BOTH day of MAY 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 \O\lMINR�S`�� Jr✓
Produced
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(Si nature of Notary Public- State oqlgrtda j' �.� —
(Si ature of Notary Pu lic- State of Flo*rid �)er is?
v $FF 936050
Commission No. FF936050 '$e�u1 �, s;°°
Commission No. FF936050 N� o �Sr d
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_ #FF936050
190nded
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Rev. 8/2/17