HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONl
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ALLAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: Q,CJ� Dan
RECEIVED
OCT 112018
Building Permit Application €tMitting Department
Planning and Development Services St, LUde County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: Roof 9GANNED
Address: 2069 S BROCKSMITH ROAD, FORT PIERCE
Legal Description: 17 35 29 N 1/2 OF SE 1/4 OF SW 1/4 LESS N 150 FT OF E 750 FT AND LESS S 150 FT OF E 629.8 FT
AND LESS E 49 FT
Property Tax ID #: 2317-341-0006-000-9 Lot No.
Site Flan Name: Block No.
ProjectiName: MATTHEWS/REROOF
Setbacks Front Back: Right Side: Left Side:
TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP METAL
PANEL ROOF SYSTEM OVER OWENS CORNING WEATHERLOCK TILE & METAL SELF -
ADHERED UNDERLAYMENT.
11HVAC LJ Gas Tank
ElElectric ❑ Plumbing
Total Sq. Ft of Construction: 5,800
Cost of Construction: $ 25,450
❑Gas Piping LJ Shutters a Windows/Doors
Sprinklers E]Generator Roof 6�12 Roof pitch
S Ft. of First Floor: 2,484
Utilities:Sewer Septic Building Height: 1 STORY
OWNER LESSEE
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CONTRACTOR
Name BARBARA MATTHEWS
Name: KYLE WHITE
Addressi: 2069 S BROCKSMITH RD
City.. iFORT PIERCE State: FL
Zip Code: 34945 Fax:
Phone No. 772-370-8776
Company: J.A. TAYLOR ROOFING INC
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4040
E-Mail: STLUCIEINN@GMAIL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: NADINE@JATAYLORROOFING.COM
State or County License: CCC1325895
It value of construction is �2500 or more, a RECORDED Notice of Commencement is required.
SUPPI.EME�NT�A#L C®NSi`R'U�CION �IfN L/�1N INO"RI1/IATCON:
�;
DESIGNER/ENGINEER: _.Not Applicable
Name:
MORTGAGE COMPANY: _ of Applicable
Name:
Address:
Address:_
City: State:
Zip: Phone:
City:I State:
Zip: , Phone
FEE SIMPLE TITLE HOLDER: _ of Applicable
Name:
Address:
City: !
BONDING COMPANY: _ of Applicable
Name:
Address:
City:
Zip: Phone:
I
Zip: Phone:
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 accorldance 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,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING 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 inspe ion If you intend to obtain financing, consult with lender or an o ney before
commencing wgpker r ding your Notice of Commencement.
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 STN day of OCTOBER
2O by
this 6TH day of OCTOBER 120 AOpby
KYLE WHITE
q�:,���ialll++++i43 ,.
KYLE WHITE
Name of person making state'rne ....I°s'l c�s9"jv�'
Name of person making stateme of\b`�`v\ MANgFr°P�y;
Personally Known xx
OR ProdiJcetld�n`fr�QQ tjpd r,
Personally Known xx OR Producec(zliie tjfie s Sri.
Type of Identification
L,�oec� �0�9�°� M
Type of Identification o bar 1s
Produced
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Produced
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Commission No. FF 936050
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(Seal)
FF 936050
Commission No. (Seal
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE,
COMPLETED
tev. 8/2/17