HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL"APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dal : Permit Number: 1.OLO
SCANNED
BY RIXIn p
Bbu ld , g Pe��mit Application JUL
Plan�ing and Development Services 06 2019
Bu, , ing and Code Regulation Division Permitting
2300 Virginia Avenue, Fort Pierce FL 34982 St' Lu e Copuntyent
Ph l:�e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xx
PERINIIT
APPLICATION FOR:
Roof
PR,
PQSED°111%IPROVEMEIVTLOGAT(QN ' �_ �r
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4840 GROVERS ROAD, FORT PIERCE
Legal Description: 13 34 39 S 147 FT OF E 105 FT OF S 299.54 FT OF E 200 FT OF W 440 FT OF N 928.60 FT OF SW
1/4 11F NE 1/4
Prop- ty Tax ID #: 1313-132-0005-010-8 Lot No.
Site P1III�an Name: Block No.
Probe t Name: BATZ/REROOF
Setbaicks Front Back: Right Side: Left Side:
f DE-T�►�I�E'I��DE5CRIP`f10°�f3FU1lORK:,��'�� �q �K�°,"��"�-� �,` y` '.``�' � �`"'I
TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP METAL
PANEL ROOF SYSTEM OVER 30# FELT UNDERLAYMENT.
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CONSTRUCTION INFORMA 01
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itj Dnal worK to be Dertormedunder
this permit - checK
a
apply:
VAC
LI
Gas Tank
Gas Piping
_
Shutters
[]Windows/Doors
lectric Plumbing
nS Sprinklers
11 p
— Generator
Roof 6/12 Roof itch
— P
Total
I
;q. Ft of Construction: 3,400
S Ft. of First Floor: 3,189
Cost o
Construction: $ 10,200
Utilities:
Sewer
Septic
Building Height: 1 STORY
P
OUVI�ER/LESSEE''
4« " R � p Y N6 i'+�Y"�' �?. ,�y � I �" %k 0 't�,�,"'� dC^"�'
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COIVTfACTOR:
Name;CHARLES BATZ & BRITTINY ALBERTSON BATZ
Name: KYLE WHITE
Address: 4840 GROVERS RD
City: !FORT PIERCE State: FL
Company: J.A. TAYLOR ROOFING INC
Address: 302 MELTON DRIVE
Zip Cgde: 34951 Fax:
City: FORT PIERCE State: FL
Phone,!No. 561-632-0850
Zip Code: 34982 Fax: 772-468-8397
E-Mail: BALB ERTSON24 Q GMAI L.COM
VI
Fill in fee simple Title Holder on next page if different
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Phone No. 772-466-4040
E-Mail: NADINE@JATAYLORROOFING.COM
from the Owner listed above)
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State or County License: CCC 1325895
IT vawu joT construction is >&Suu or more, a KLLUKULD Notice of Commencement is required.
TCN5RUC'SUPPLEMENATIONLIE LA
1%N'FORMTIA
d
DESIGNER/ENGINEER: Not Applicable pp
MORTGAGE COMPANY: Applicable
Name:
_L_�146t
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
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Zip: Phone:
FEE SIMPLE TITLE HOLDER: of Applicable
BONDING COMPANY: of Applicable
Name:
_
Name:
Address:
Andress:
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 c�'Irtify that no work or installation has commenced prior to the issuance of a permit.
St JLucie 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
str cture. 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,
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accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
V ARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
ir6provements to your property. A Notice of Commencement must be recorded and posted on the jobsite
b0fore the first inspe If you intend to obtain financing, consult with lender or an attorney before
c6mmencin w r rding your Notice of Commencement.
�I
ignature of Owner/ Lessee Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
I�COUIN OF STLUCIE
COUNTY OF STLUCIE
l
jThe forgoing instrument was acknowledged before me
The forgoing instrument was acknowledgecLbefore me
this 2nH day of JUNE 20 by
this 27TH day of JUNE 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 ��OggaE9III11111,J
Type of Identification
Produced �a �ptP1E MAN69 Y'�r
Produced r
1em�h°er IS �A9 s�
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��'°�C����ticfdSSlprvA�`S9f`'�i�
or 1S
(Signature of Notary Public- State of'Flo ilia) W '
#FF 936050
(S)qaatur of Notary Public- State of Flo.'ridao)� _
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Commission NO. FF936050 �� el°• Qa
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_ XFF936050 °
Commission No. FF936050 'i% ea o ter=
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
j
RECEIVED
, I
DATE
COMPLETED
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Rev. 8/2/17