HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Building Permit Application
Planning and Development Services Al.� ' 4 20113
Building and Code Regulation Division ST. L�acih > ^*'I, narmitung
2300 Virginia Avenue, Fort Pierce FL 34982 - �T ""' --
W1ne: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xx
PE14''MITAPPLICATION
FOR:
Roof
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Address: 6289 S HEADER CANAL ROAD, FORT PIERCE
Legal ,Description: '14 36 28 S 359.78 FT OF FOL DESCRPROP: COMM AT PT 50.50 FT S AND 143FT W OF NE COR OF SEC 14,
TH S iOODEG 09 MIN 47 SEC W 60 FT TO POB, THE CONT S 00 DEG 89 MIN 47 SEC W // WITH E LI SEC 554.22 FT, AND MORE
Propirty Tax ID #: 3214-111-0004-010-8 Lot No.
Site.Pilan Name: Block No.
Project Name: ,SMITH W /REROOF
Setbacks Front, Back: Right Side: Left Side:
OFF SHINGLE, RE -NAIL DECK. INSTALL NEW JAT 5V CRIMP METAL PANEL ROOF
=M OVER 30# FELT UNDERLAYMENT.
Additional work to be erformed under this permit —check all apply:
HVAC Ei Gas Tank Gas Piping _ Shutters Q Windows/Doors
❑ Electric 0 Plumbing Sprinklers Li Generator W1 Roof 5/12 Roof pitch
Total q. Ft of Construction: 5500 S . Ft. of First Floor: 3,446
18 700 1 STORY
Cost of Construction: $ Utilities: Sewer Septic Building Height:
OU11fER%LESSEEa�rrF� `
CONTRACTOR
Named WILLIAM SMITH
Name: KYLE WHITE
Addrel s: 6289 S HEADER CANAL RD
City: State: FL
Company: J.A. TAYLOR ROOFING INC
Address: 302 MELTON DRIVE
Zip Code. 34987 Fax:
Phone No. 772-201-1404
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
E-M4;ll: RANCHFlRE9@AOL.COM
Phone No. 772-466-4040
Fill in',fee simple Title Holder on next page ( if different
E-Mail: NADINE@JATAYLORROOFING.COM
from the Owner listed above)
State or County License: CCC1325895
It vaiuel of construction is �Z500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER:
Name:
Address:
City
Zip'k
_Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
I
State:
Phone
FEE
Name:
Address:
Zip'f
SIMPLE TITLE HOLDER: _Not Applicable
BONDING COMPANY: _ of Applicable
Name:
Address:
City:
Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certI ify that no work or installation has commenced prior to the issuance of a permit.
St: Lutie 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 conlsideration 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 folllowing building permit applications are exempt from undergoing a full concurrency review: room additions,
acces�ory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WANING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencin work oLrAxeoing your Notice of Commencement.
. III
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COIf1NTY OF STLUCIE COUNTY OF STLUCIE
The forgoing instrument was acknowledged�hYefore me The forgoing instrument was acknowledge efore me
this I22ND day of AUGUST 2� 1 p by this 22ND day of AUGUST 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 Identificatip
Type of Identification Type of Identification 3aN���P1E M� A�/'"e�s,�
Proc�luced °t°1°°!'.3HP04444�® Produced P^°�PO Fs F�
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(Sit'ature of Notary Public- State of�orid�k a.� = (Si ature of Notary Public- State of Fiord #FF936050 e
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CommlS$iOn N0. FF936050 eal #FF936050 5 eQ` FF936050 aC�./ °�aS8Not�rysz �,�
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
I
RECEIVED
l
DATE
COMPLETED
Rev. 872/17