HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL
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PLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED G /�
Permit Number:
<, RECEIVED
t 'I i M__' sy SEP 19 7.018
Building Permit ApplicatioA�l/ Permitting De artme
Planning and Development Services
BuiDIing and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
Residential xx
St. Lucie Countv
PERMIT
APPLICATION FOR: Roof
PwRO
OSED IMPROVEMENT LOCATION ,
,..J,.n = to Al
Addr ss: 204 TUMBLIN KLING ROAD, FORT PIERCE
Legal ,Description: FLA COAST LINE CANAL AND TRANS CO'S S/D S 1/2 OF LOT 2 AND ALL LOT 7
Prop I;I y Tax ID #: 2434-801-0003-000-9
Site Plan Name:
Proje t Name: STEWART/REROOF
Setbacks Front Back: Right Side
Left Side:
Lot No.
Block No.
TEAF, OFF SHINGLE, RE -NAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP METAL
SKYLL PAN ROOF SYSTEM OVER SELF -ADHERED UNDERLAYMENT. REPLACE ONE 3X3
IGHT.
CONSTR'UCTIO"N INFORMATION
ii jional work to be erformed under this permit c ec all that apply:
LLIHVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
Ih Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Tota 'Sq. Ft of Construction: 5,000 S Ft. of First Floor: 5,956
Cost of Construction: $ 25,700 Utilities:Sewer [] Septic Building Height: 1 STORY
I
O NER/LESSEES
�. .L �
CONTRACTOR �.
q.�ma
Name
Addr<-ess.
City-'
Zip
Pho,
E-
Fill i
fro
BILL & MARLENE STEWART
Name: KYLE WHITE
Company: J.A. TAYLOR ROOFING INC
204 TUMBLIN KLING RD
FORT PIERCE State: FL
!ode: 34982 Fax:
a No. 772-464-5182
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4040
E-Mail: NADINE@JATAYLORROOFING.COM
Fail:
fee simple Title Holder on next page ( if different
the Owner listed above)
State or County License: CCC1325895
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
r'-
�� 5
SUPPLE'MEO%
u
COIVSTRbtfi N `LIEN° LAHV"INFORMATION"
DESIGNER/ENGINEER:
Name:
Address:
City:`'�
Zip:.111
_j.^ot Applicable
MORTGAGE COMPANY: L_*ot Applicable
Name:
Address:
City: State:
Zip: Phone:
State:
Phone
I'I
FEEIMPLE
Na
Address:
City:"I
Zip:
TITLE HOLDER: _ of Applicable
�e:
BONDING COMPANY: _ of Applicable
Name:
Address.
City:
Phone:
I
Zip: Phone:
:R/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
/ that no work or installation has commenced prior to the issuance of a permit.
County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
> in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
e. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
deration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
dance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
owing building permit applications are exempt from undergoing a full concurrency review: room additions,
ry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
ZING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
vements to your property. A Notice of Commencement must be recorded and posted on the jobsite
the first inspection. If you intend to obtain financing, consult with le er ocean attorney before
encine worlr or�ordinE vour Notice of Commencement. //
i42�
I
Sign�aiture
of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
ST
TE OF FLORIDA
STATE OF FLORIDA
COUNTY
OF STLUCIE
COUNTY OF STLUCIE
The
�,orgoing instrument was acknowledged -before me
SEPTEMBER
The forgoing instrument was acknowledgPd-before me
this 19TH day of SEPTEMBER Z( by
this
19TH day of ZQlby
T
KYL
I WHITE
KYLE WHITE
Name of person making statement �,: a?�`A��Ap�
Name of person making statement
Persil nally Known xx OR Produced Ides #ftaklbn , d9c Am,
Personal) Known xx OR Produced Identification
Typ I of Identification ��1v'�SSl041"°os' �o~,
e
Type of Identification
Produced Q; Obar 1S2 i°°
:.Produced ya;,'v9,pyy.
m #FF 936050
°°,
- hhA4lSSlpy ° Fy''o
. .
(Signature
of Notary Public- State of Florin[a')4���f��;rysao;����o?���
Cigna re of Notary Public- Stat of�Y Aida')' �e � m
FF 936050 (S"al; ��d9�TA9eF�9��i•?�
° OFF 36p� o,�a
FF 936050 (� 0
CO
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