HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL
CABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application Nop'o7?0�
Planning and Development Services Permitrin g
Building and Code Regulation Division St Luce ooartm�n
2300 Virginia Avenue, Fort Pierce FL 34982 upty t
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XX
IERIVIITi APPLICATION FOR: Roof _Ada , �•
SCANNED
'ROP,OSED I' "' ""OVEMENT LC►CATION
-1-1_____ RRn9 G INIIIAN RIVER r1RIVF FORT PIFRr F St Lucie County
nUul caa. I - - - - - - - - -
Legal Desgription:
HAL S THOMAS RE-S/D OF LOTS 1, 2, 3, 4, OF RANSOMS S/D OF LOT 1 S 188.5 FT OF LOT 1 LYG
ELY OF ELY RNV OF FEC RR - LESS IND RIVE DR
Property Tax ID #: 3519-501-0005-000-5 Lot No.
Site Plan Name: Block No.
Project Na me: DEVENS/REROOF
Setbacks Front Back: Right Side: Left Side:
TEAR OFF ROLL ROOFING, RE -NAIL DECK. INSTALL POLYGLASS 3-PLY MODIFIED BITUMEN
TAPERED SYSTEM (W-66)
t:,V-IYJ LIrSV �:. 1,1 „l`JI V� IIV:P lll,A7VIA I IaV,1�Y ��, � + I a h
Additional, work to be nertormed under this permit —check all apply:
11HVAIIC Gas Tank ❑Gas Piping _ Shutters . Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator W1 Roof 2 Roof pitch
Total Sq. Ft of Construction: 2,800 S . Ft. of First Floor: 1,915
Utilities: Sewer Septic Building Height: 1 STORY
Cost of Con' struction: $ 18,200
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ON1/NER%LESSEE $gypn
CONTRACTOR`,
ag
Name GUY DEVENS
Name: KYLE WHITE
Address: 18609 S INDIAN RIVER DR
Company: J.A. TAYLOR ROOFING INC
City: FORT
PIERCE State: FL
Address: 302 MELTON DRIVE
Zip Code: 134982
Fax:
City: FORT PIERCE State: FL
Phone No.
954-263-5315
Zip Code: 34982 Fax: 772-468-8397
E-Mail:
Phone No. 772-466-4040
Fill in fee sjmple
Title Holder on next page if different
E-Mail: NADINE @ JATAYLORROOFING.COM
State or County License: CCC1325895
from the Olwrier
listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
-UPPLEMENTAL`CQNSTRUaCTI.QN
��,
LIEN LAIN INFORMATION ,°s
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DESIGNER/ENGINEER: _Not
Applicable
MORTGAGE COMPANY:
L4fot Applicable
Name: I
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Not Applicable
BONDING COMPANY:
_ of Applicable
Name: I
Name:
Address'.
Address:
City: I
City:
Zip: Phone:
Zip: Phone:
I
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify thalt 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 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,
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 you intend to obtain financing, consult with lender or an}ttor y before
commencing w-or r�eccnr ins vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTYIOF STLUCIE
COUNTY OF STLUCIE
The forgoing instrument was acknowledge before me
29TH OCTOBER
The forgoing instrument was acknowledged before me
this 29TH day OCTOBER 20 (p by
this day of 20 by
of
KYLE WHITE \\1I1�lj��
KYLE WHITE
Name of person making state ..., F��i,
e��
Name of person making statement
Person allyi Known xx OR Produ#d 's;?ivc•
Personally Known xx OR Produced Identification
ntification=gNber fs?o��A'�y
of Id entification
PYope duoced
Prope
duced \\1\\�oO\NttMA�jR
0-4
#FF 936050 ; Q
_� ; �,� ONter 1S2 A9 •s
LOL
"S�
(Signatureiof Notary Public- State of Flo ����g �\\�\
(Signature of Notary Public- State of FlisrZ�) #FF936050 ;a-
�i�� �rnytanIC
Commission No. FF 936050 (Seal)
Commission No. FF 936050 ��+;o
ST
i
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev. 8/2/17 1