HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE I .MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d
Date: Permit Number:
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Building Permit Application
Planning and Development Services Y.,�'errnitting
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 —
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IIVI'PROUEMENT L CµATION "`
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Address: 2826 FOREST PLACE, FORT PIERCE (HOUSE) by/
Legal Description:
MARAVILLA PLAZA BLK 3 LOTS 5 AND 6 We County
Property Tax ID #:
Site Plan Name:
Project Name:
2421-802-0038-000-6
WOUTERS/REROOF
Setbacks Front Back: Right Side: Left Side:
Lot No.
Block No.
�A ,.�
DETAILED DESCRIPTION OF WORK
TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP METAL
PANEL ROOF SYSTEM OVER 30# FELT UNDERLAYMENT.
H VAC
Electric
0 Plumbing
Sprinklers
11 Windows/Doors
❑✓1 Roof 3/12
Total Sq. Ft of Construction: 3,800 S Ft. of First Floor: 2,504
Cost of Construction: $ 14,680 Utilities:cnSewer Septic Building Height: 1 STORY
O,WiN'ER%LESSEE
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Name ELAINE WOUTERS
Name: KYLE WHITE
Address: 2826 FOREST PL
Company: J.A. TAYLOR ROOFING INC
Address: 302 MELTON DRIVE
City: FT PIERCE State: FL
Zip Code: 34982 Fax:
City: FORT PIERCE State: FL
Phone No. 772-216-3676
Zip Code: 34982 Fax: 772-468-8397
E-Mail:
Phone No. 772-466-4040
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.
=SUPPLEMENTAL CQNSTRUCTIOI
LIEN LAW INFORMATION
DESIGNER/ENGINEER:
_ otApplicable
MORTGAGE COMPANY:
_j�NotApplicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
t Applicable
BONDING COMPANY:
i/IClot 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 norepresentation 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, srimming 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 on. If ou intend to obtain financing, consult with lender or an attorney before
commencing w9rWr recor ng 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 acknowledgedJefore me
The forgoing instrument was acknowledged before me
this 7TH day of NOVEMBER 20 1 If by
this NTH day of NOVEMBER 20jC y
KYLE WHITE
KYLE WHITE
Name of erson makingstat 1tl1S'. ll�/i
Name of person making statement
Personally Knownp xx OR Pro ��'://�i
Personally Known xx OR Produced Ide�i§41r0ljlll�j�i
Type of Identification Sao`;' s 'mq�P�ouo� ;6d
= 090966Jj ;gy=_
Type of Identification ��1) • ,FIWgV��'•
�ao� y Ny�PaPu09 j•.•.�%
Produced
Producedir
(S gnature of Notary Public- State d(!� '' a �•'` 3 ,�a��.��
(Signature of Notary, ublic- State of Floc' .a
Commission NO. FF 936050
Commission No. FF 936050
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17