HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPI
Date: T
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Num
��rArUri9ED
Building PermiR ficatio�
Plannind and Development Services
Buildin' and Code Regulation Division
2300 Vi 'ginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
AUG 3 0 2018
Permitting Department
St Cle unty, FL
PERMIT
APPLICATION FOR: RoofEl
PROPOSED
IMPROVEMENT LOCATION:
Addressi�l 1206 WHITE OAK LANE, FORT PIERCE
Legal Description: 9 36 40 FROM SE COR LOT 1 BLK 22 RIVERDALE YACHT CLUB ESTATES UNIT 2 RUN S 50 FT,
THE W ;7.5 FT, TO POB, TH CONT W 102.5 FT, TH S 167.54 FT, THE E 102.5 FT TH N 167.54 FT TO POB
3409-431-0001-000-5
Propert�i�Tax ID #: Lot No.
Site Plan Name: Block No.
Project lame: HUFF/REROOF
Setback' Front Back: Right Side: Left Side:
DETAI EIJ DESCRIPTION OF WORK:
TEAR CFF SHINGLE, RE -NAIL DECK. INSTALL J A TAYLOR ROOFING 5V CRIMP METAL PANEL
ROOF YSTEM OVER SELF -ADHERED UNDERLAYMENT (32sq).
CONSTRUCTION INFORMATION:
itior al work to be erformed under this permit —check all apply:
❑H VAC Gas Tank []Gas Piping _ Shutters ❑ Windows/Doors
❑ El ,'Ctric ❑ Plumbing ❑Sprinklers ❑ Generator g Roof Roof pitch
Total Sq. IFt of Construction: 3,200 S . Ft. of First Floor: 3,413
Cost of onstruction: $ 12,600 Utilities: 0Sewer ❑Septic Building Height: 1 STORY
OWNER/LESSEE:
CONTRACTOR:
Name ,
Address
City: Fd
Zip Cod
Phone Nlo.
E-Mail:
Fill in feed
from th
TEVEN & LESLEY HUFF
Name: KYLE WHITE
Company: J.A. TAYLOR ROOFING INC
Address: 302 MELTON DR
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4040
E-Mail: NADINE@JATAYLORROOFING.COM
State or County License: CCC 1325895
11206 WHITE OAK LN
RT PIERCE State: FL
34982 Fax:
270-361-9386
§CHUFF2003@GMAIL.COM
simple Title Holder on next page if different
IOwner listed above)
if value of Construction is $2500 or more, a RECORDED Notice of Commencement is required.
U" M M&L CAN I TI
DESIG ER ENGINEER: x Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: l
_
Name:
Address:
Address:
City: Ji State:
City: State:
Zip: I'I Phone
II
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name. I
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: 11 Phone:
11
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 accord�i ce 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,
accessorystructures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNI�' IG TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your prop rty. A Notice of Commencement must be recorded and posted on the jobsite
before tie first inspection you intend to obtain financing, consult with lender or an ey before
commen'cine work dinE vour Notice of Commencement.
I
Signat r
of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE
F FLORIDA
STATE OF FLORIDA
COUNI
I OFSTLUCIE
COUNTY OF STLUCIE
The forg
Jing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 27TH
' day Of AUGUST 20ffby
this 27TH day of AUGUST zoo by
KYLE WHI
rE
KYLE WHITE
Name of person making statement
Name of person making statement
Persona:
ly Known xx OR Produced Identification
Personally Known xx OR Produced Identification
Type of
dentification
Type of Identification
Produced
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DATE
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