HomeMy WebLinkAboutBUILDING PERMIT APPPLICATIONDec/05/201810:31:50 AM Wells Fargo 9043612158
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ALL APPLICABLE IN 0 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED.
Date: SCANNED Permit Number.
BY
St. Lucie County
RECEIVED
Building Permit Application
Planning and DevelopmentServices DEC 05 2018
Building and Code Regulation Division
2300 trirginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof Q
PROPOSED IMPROVEMENT'LOCATION-. _ • .
Address:� 11123 Lands End Chase, Port St. Lucia FL 34986
Legal Description: Reserve Plantation- Phase IIA LOT 14
PropertyiTax ID #: 3321-803-0020-OOM Lot No.14
Site PlanlName: NIA Block No. WA
Project Name: WA
Setbacks FfontNIA Back: NIA Right Side: N/A Left Side: NIA
DETAILED DESCRIPTION OF WORK.
Remove/ replace all existing tile on roof, install new poly -glass vapor barrier on decking, install new
drip edge. Replace all existing lead boots on vents and off ridge vents. Haul away all roofing debris
,j1 V I lW_ eJ iz�t`(wE t�1Z = �S i✓u� s AkS per.: WJ�
I'r•nnrc-rtotrr-rrnnt inttnnnnnTlnnt. " • III
HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors
L�Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq.' Ft of Construction: 4086 62.5 sq S . Ft. of First Floor. NIA
Cost of Construction: $ 62,885.00 utilitiest Sewer Building Height: N/A
OWNER/LESSEE:
CONTRACTOR: .
Name Gary Cantrell
Name: KEVIN W HENSLEY
Address' 111281.ands End Chase
Company: KLT Construction Inc
Address:
City: PortSt. Lucie State.FL
Zip Cade: 34986 Fax: N/A
Phone No.772370-6492
City: Jacksonville Beach State:FL
Zip Code: 32250 Fax:
Phone No. 904-813-8613
E-Mail: kilwnstruction@att.net
State or County License: CCC1330001
E-Mall:N/A
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If value of construction is 52500 or more, a RECORDED Notice
required.
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Dec/05/2018 10:31:50 AM Wells Fargo 9043612158 2/17
0
SUPPLEMENTALCON$TRUCTION LIEN°LAW INFORMATION:.; "
DESIGNER/ENGINEER: Not Applicable
Name i
MORTGAGE COMPANY: LNotApplicable
Name
Address:
Address:
City: State:_
Zip: Phone
City: State:_
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: &Not Applicable
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 cr installation has commenced prior to the issuance of a permit.
St.LucieCountymakes noreprese tationthatisgrantingapermitwillauthorizethe permitholdertobuild the subject structure
which is inlconflictwith any applicable Home Owners Association rules, bylaws orand 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 thefirst inspection. If you intend to obtain financing, consult with lender or an attorney before
commencine work or recording vour Notice of Commencement.
Signature of Owner/ Lessecl/Comtracfo s Agent for Owner
Signaturi dfCoatjor/ilcense Holder
STATE OF FLORID ✓� L
COUNTY OF
STATE OF % UAL",
/�IA
COUNTY OF �'7)
The forgoing instrumentwas acknowledged before me
this�dayof�%1'= ��= r.20 by
The forgoing instrument was acknowledged before me
thisFndayof,{Ij �, = C 20�by
KWIN �V• 1"t`tz— SL.Cti%
kev)nl
Name of person making statement
Personally Known OR Produced Identification sc
Type of Identification
ProduDced�07 (--J'yt—
Name of person making statement
Personally Known OR Produced Identification _
Type of Identification
Produced it_ 7c—
(Si atureofNotaryPublic•StateofF)Q
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Rev.8/2/17