HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -1
Date: � � � 13 \ 1Permit Number:
RECEIVE®
Building Permit Application NOV 13 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie Geun 4 Pgrmikvng
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: Roof -- SW-%h%\-k_ �r-� i tX+ 5f%A.
Address:
AIVI FKUVtIVI UNIJ' LUG( H`I`Il1IV
7901 WINTER GARDEN PARKWAY, FORT PIERCE
Legal Description: LAKEWOOD PARK - UNIT 5 BLK 49 LOT 10
Property Tax ID #: ' 1301-605-0242-000-2
Site Plan Name:
Project Name: VANLIESHOUTiREROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF Wt7R1C
Lot No.
Block No.
TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW OWENS CORNING DURATION SHINGLE
(FL#10674.1) ROOF SYSTEM - 23SQ OVER OWENS CORNING WEATHERLOCK G (FL#9777.1).
ON FLAT PORTION INSTALL POLYGLASS W-66 (FL#1654.1) - 7SQ
C,ONSTR'UCTIO€N INFORMATION
Additional work to be nertormed under this permit —check
all that apply:
�HVAC 0 Gas Tank
Gas Piping
11 _ Shutters
❑ Windows/Doors
Electric ElPlumbingSprinklers
❑ Generator
W1 Roof 3/12 Roof pitch
Total Sq. Ft of Construction: 3,000
Sq. Ft. of First Floor: 2,160
0Septic
Cost of Construction: $ 13,715
Utilities: Sewer
Building Height: 1 STORY
OU1/NER%LESSEE L - wa04CONI"RACTOR.
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Name DANIEL VANLIESHOUT
Address: 7901 WINTER GARDEN PKWY
Name: KYLE WHITE
Company: J.A. TAYLOR ROOFING INC
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Code: 34951 Fax:
Phone No. 609-703-4125
City: FORT PIERCE State: FL
Zip Code: 34982 - Fax: 772-468-8397
Phone No. 772-466-4040
E-Mail: BIGDANVAN@YAHOO.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
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN
g „ , ..... ...
&, ,LAW FIG ON
;
DESIGNER/ENGINEER: _
of Applicable
MORTGAGE COMPANY:
_C*at Applicable
Name:
Name:
Address:
Address:
City:-
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
of Applicable
BONDING COMPANY:
LWbt Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
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 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 in ction. If you intend to obtain financing, consult with ler er or a attorney before
commenci koV recording 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 acknowledgedefore me
The forgoing instrument was acknowledg�efore me
this 7TH day NCVEMBER 201 by
this 7TH day of NOVEMBER 20� by
of
KYLE WHITE \p1��lJ///
KYLE WHITE
Name of person making statement�o����gp\ �•...,••F,�ii,
Personally Known xx OR Produced 1�2nttfiaE3ICNFL�.
Name of person making stat \ ENE MAN ,,
Personally Known xx OR Prodt aafa
Type S,
_e of Identification �m 20 9 ;
Ype of Identification Aber 7s F/o�.•
•
Produced
&oduced
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(S gnature of Notary Public- State of Florida ��i// �BS o\
(Signature of Notary Publi -State o .....
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FF sssoso (Seal)
FF sasoso lN 1111�\��
Commission No.
Commission No. (Seals
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev. 8/2/17