HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
i
ALL APPLICABLE IN LIST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11\ \�\1 Permit Number:
., . IV—
EIVED
Building Permit Applicatio
Planning and Development Services CST.�L�u_7unty,
t 0i$Building and Code Regulation Division2300 Virginia Avenue, Fort Pierce FL 34982 Permitting
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: Roof _ M%-Vg1 a►va SCANNED
PROPOSED IMPI kOVEMENT L'OCATIO(N
7ROA 17r)PP9ZT DI Ar`G Dr1RT DIFRr`F /f,ARAr,F1 LUCle County
MUUI CJJ. ---
Legal Description:
MARAVILLA PLAZA BLK 3 LOTS 5 AND 6
Property Tax ID #: 2421-802-0038-000-6 Lot No.
Site Plan Name: Block No.
Project Name: WOUTERS/REROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF,WQRK ' t
TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP METAL
PANEL ROOF SYSTEM OVER 30# FELT UNDERLAYMENT.
:CONSTRUCTION INFORMATION
Additional workkto be nertormed under
11HVAC I_J Gas Tank
this permit —check
Gas Piping
a11
apply:
_ Shutters
O Windows/Doors
11Electric ❑ Plumbing
[]Sprinklers
Generator
W1 Roof 3�12 Roof pitch
Total Sq. Ft of Construction: 700
S�Ft.j of First Floor: 440
Cost of Construction: $ 3,520
Utilities: I
_I
Sewer
Septic
Building Height: 1 STORY
"OWNER/LESSEE:
CONTRACTOR -
Name ELAINE WOUTERS
Address: 2826 FOREST PL
Name: KYLE WHITE
Company: J.A. TAYLOR ROOFING INC
Address: 302 MELTON DRIVE
City: FT PIERCE State: FL
Zip Code: 34982 Fax:
Phone No. 772-216-3676
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4040
E-Mail: NADINE@JATAYLORROOFING.COM
State or County License: CCC1325895
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
.SUPPLEMENTAL
a
CONSTRUCTION LIEN Li4AW INFORMATION
?n`A p�;-.A✓', ,30� ry to'6q'',E 4„1'a'�t Gat ., "^$ .3 h. :.abi [�} M . n'a nei n, ,�,-. ` mfb'MfA agn L&.l. x 91N
DESIGNER/ENGINEER:
Name:
Address:
"ot Applicable
MORTGAGE COMPANY:
Name:
_L—Net-Applicable
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
__LPdot Applicable
BONDING COMPANY:
Name:
_IVot Applicable
Address:
City:
Zip: Phone:
City:
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 y pro erty. A Notice of Commencement must be recor and posted on the jobsite
before the first ' ectio If you intend to obtain financing, consult with er an attorney before
commencin ork or re rdin our Notice of Commencement.
Signa ure 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 b fore me
this 7TH day NOVEMBER 2��y
The forgoing instrument was acknowledged efore me
this 7TH day of NOVEMBER 20by
of
KYLE WHITE
KYLE WHITE
Name of person making state d ENE ///e��
Name of person making statemerltX p1NE MA�y �' �iip
Personally Known xx OR Prodt� • t fat ���
Personally Known xx OR Produce`oe �I w f�� 9 �
••
Type of Jdentification . 0
• p is �o'.
Type of Identification N y
V is
J fiber
Produced �a�,0 r'o�9cn a
tuber ,o%
Produced _=o°e ao�ym
mcn:
�cn�
#FF 936050 a
'zyo #FF 936050
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' Bon
Rj'
i 9 .�
(Signature of Notary Pu lic- State o �.... •'•F�°��`�
IC
(i ature of Notary Pu ic- State of Flafrtyl4'••.:�ry... •F�p`� '
�ii��[IC STAZE��\��N�
STATE�F�°
Commission NO. FF 936050 ('s'��19���'"°
Commission No. FF 936050 ( IN1611i'�11°°°°
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev. 8/2/17