HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI
ALL APPLICABLE, INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
e ajiMIT-1
SCANNED
- -BY
MIMI=RECEIVED
Building Permit Application
Planning and Development Services MAY 1 1 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie Count ,Permitting
Phone: (772) 462-1553 Fax: (772) 46 -1578 Commercial R �s'i'dintia`� X
PERMIT APPLICATION FOR: Rgof
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PROPOSED IMPROUEMENTLOCATION
Address: 628 KEARNEY ROAD, FORT PIERCE
I
Legal Description: WHITE CITY ESTATES BLK 1 LOT 14 AND W 1/2 OF N 1/2 OF LOT 15
Property Tax ID #: 3410-601-0018-000-2 Lot No.
Site Plan Name: Block No.
Project Name: MONTANO/REROO�
Setbacks Front Back: Right Side: Left Side:
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DESCRIP
DETAILED a lON'OF WORK
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TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW PETERSEN EDGE-LOC METAL PANEL
ROOF SYSTEM OVER OWENS CORNING WEATHERLOCK TILE & METAL SELF -ADHERED
UNDERLAYMENT. POLYGLASS MODIFIED BITUMEN (2sq) ON FLAT PORTION.
Additional work to be nertormed under this permit —check all apply:
11HVAC L_j_I Gas Tank Gas Piping _ Shutters ❑ Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof 5/12 Roof pitch
Total Sq. Ft of Construction: 2,600 S Ft. of First Floor: 1,272
Cost of Construction: $ 11,200 Utilities: Sewer Septic Building Height: 1 STORY
OWNER/LESSEE
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CONTRACTOR
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Name RAFAEL MONTANO
Name: KYLE WHITE
Company: J.A. TAYLOR ROOFING INC
Address: 628 KEARNEY RD
Address: 302 MELTON DRIVE
City: FORT PIERCE State::FL
Zip Code: 34982 Fax:
City: FORT PIERCE State: FL
Phone No. 772-489-6030
Zip Code: 34982 Fax: 772-468-8397
E-Mail: RMLAWNSERV@AOL.COM
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.
"SUA RFUCTIONiIIENLAWFQIMTICIN
�PLEMENi'AL�CnONS
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
—Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
I
Zip: Phone:
'
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I
OWNER/ CONTRACTOR AFFIDVIT:
I certify that no work or installation has c
lication is hereby made to obtain a permit to do the work and installation as indicated.
fenced 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 i 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 requ
in accordance with the approved plans, the
permit, I do hereby agree that I will, in all respects, perform the work
a 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 ti
improvements to your property. A N
before the first in i n. If you into
commencing or cording our
Record a Notice of Commencement may result in your paying twice for
tice of Commencement must be record and posted on the jobsite
id to obtain financing, consult with I er or n attorney before
Jotice of Commencement.
oe
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 acknowledged
before me
The forgoing instrument was acknowledged before me
this 7rH day of MAY 20
by
this 7rH day of MAY , 20_ by
KYLE WHITE
KYLE WHITE
Name of person making statemeni,
Name of person making statement
Personally Known xx OR Produced Identification
Personally Known xx OR Produced Identification
Type of Identification �tv;99911i0PPB>P/o P®®�i,
Type of Identification 0%%ii,lplaepe,
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Produced vd°°����M'�1RFS
Produced ,ao``°qp�N� AFd�O�W
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Signature of Notary Public- State : Florida�F 93oo
(Si ature of Notary Public- State of F_pri #FF 936050 ; Q
2G ° ,bp nded�b���o • o``�
Commission No. FF936050 !ST'fS;,ea�NotaryS;m�Q�a��
s��' •'• Bo qeynded
Commission No. FF936050
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SUPERVISOR
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VEGETATION
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DATE
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DATE
COMPLETED
Rev. 8/2/17