HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ���� ✓� O Permit Number: n /o"D
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Building Permit Application per4j/tt01/®'101
Planning and Development Services SC :'o9
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 y eot
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: Roof
PROPOSED 'TNIPRO,\/E'11/IENT®LOCATI:QN
Address: 3409 AVENUE I, FORT PIERCE St Lucie Co(Int`g
Legal Description: SABAL PALM S/D BLK 1 LOT 8
Property Tax ID #: 2405-715-0007-000-3 Lot No.
i
Site Plan Name: Block No.
Project, Name: ARMSTRONG/REROOF
Setbacks Front Back: Right Side: Left Side:
TEARIOFF ROLL ROOFING AND SHINGLE, RE -NAIL DECK. INSTALL POLYGLASS MODIFIED
BITUMEN TAPERED SYSTEM (W-66) ON FLAT PORTION (21sq). ON PITCHED INSTALL OWENS
CORNING SHINGLE ROOF SYSTEM OVER 30# FELT UNDERLAYMENT (9sq)
Aaaitional worK to ne errormea unaer tnis permit — cnecK an apply:
FHVAC Ei Gas Tank Gas Piping _ Shutters ❑ Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof 2/12 Roof pitch
Total Sq. Ft of Construction: 3,000 5 Ft. of First Floor: 1,680
Cost of Construction: $ 17,625 Utilities: Sewer Septic Building Height: 1 STORY
01NNER/LESSEE ; a,�, ;
CTO
CNTR R
Namel MILDRED ARMSTRONG
Name: KYLE WHITE
Company: J.A. TAYLOR ROOFING INC
Address: 3409 AVE I
City: FORT PIERCE State: F�
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Code: 34947 Fax:
Phone No. 772-461-5280
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4040
E-Mail:
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
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
I
DESIGNER/ENGINEER: /Not Applica
Name:_
Address:
City:
Zip:
Phone
State:
FEE SIMPLE TITLE HOLDER: \/Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:_
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certifylthat no work or installation has commenced prior to the issuance of a permit.
St. LuciejCounty 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 yo roperty. A Notice of Commencement must be recorded and ed on the jobsite
before�the first i ection.yyou intend to obtain financing, consult with lender or attor before
commencin rk or rec rn our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
I
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OF STLVCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledgeMefore me
this 29TH day of OCTOBER 1 20jJ by
i
this 29TH day of OCTOBER 20 16 by
KYLE WHITE 1111illlllli//
KYLE WHITE
Name of person making statemeo`Pp\N....•.F�is��
Name of person making statement
Personally Known xx OR Producec�%dZ-�I �'ll�' _�;
Personally Known xx OR Produced Identification
Type of Identification : �o,¢�bev 1s?o �� :
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Type of Identification `����o11d1EN/
Produced = z . *
Produced �0"AlO��..
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#FF936050 :o
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(Signature of Notary Public- State of Flori gA-4Q &t1C 111111h;i "1 ������
(Si nature of Notary ub is -State of Flori ��. #FF936050
9 .��,BoA6 •OQ
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FF 936050
Commission No. (Seal)
Commission No. FF 936050 ( . Set ;:•
9C/C,•STASeq
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
j
COUNTER
REVIEW
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REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17