HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONN
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a r �-Lg" Permit Number: I
Building Permit Application RCC6rVED
Planning and Development Services DEC 1 '81018
Building and Code Regulation Division Pennittln
2300 Virginia Avenue, Fort Pierce FL 34982 St. Luse cpppryent
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof
•G4
Address
IMPROVEMENT LOCATION:
4006 AVENUE M, FORT PIERCE
Legal Description: SUNLAND GARDENS BLK 25 LOT 18
Property Tax ID q:
Site Plan Name:
Project Name:
2405-601-0464-000-4
URSO/REROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED'DESCRIPTION OF'WORK:
Lot No.
Block No.
TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP METAL
PANEL ROOF SYSTEM OVER SELF -ADHERED UNDERLAYMENT (13sq). ON FLAT SECTION
INSTALL POLYGLASS (W-66) MODIFIED BITUMEN ROOF SYSTEM (1sq)
CONSTRUCTION INFORMATION:
LJHVAC LJ Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction: 1,400
Cost of Construction: $ 10.100
uLL — bucl.n Oil OIJIJIy.
11
Piping _Shutters ❑Windows/Doors
nklers Generator ❑✓— Roof 4/12 Roof pitch
_ S . Ft. of First Floor: 1,506
Utilities:Sewer Septic Building Height: 1 STORY
OWNER/LESSEE:
CONTRACTOR:
Name CHARLES URSO
Name: KYLE WHITE
Address: 108 S 35TH ST
Company: J.A. TAYLOR ROOFING INC
City: FORT PIERCE State: FL
Zip Code, 34947 Fax:
Phone No.172-489-9373
Address: 302 MELTON DRIVE
City: FORT PIERCE State. FL
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4040
E-Mail: CHARLESURSO@BELLSOUTH.NET
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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW.INFORMATIbaN,:..
DESIGNER/ENGINEER:
Name:
of Applicable
MORTGAGE COMPANY:
Name:
4,Let Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ of Applicable
BONDING COMPANY:
Name:
--L Mot Applicable
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 p perty. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspe on you intend to obtain financing, consult with lender or an at orney before
commencingwor r rec r in our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of ontractor/Licen a Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST WCIE
COUNTY OF STLUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledge, before me
this 14TH day of DECEMBER
this14TH dayof DEEMBER�y 20 by
KYLE WHITE \olllllllllll
KYLE WHITE
Name of person making state 0 •....•• FS ii��
Name of person making statem H1111110101111'
Personally Known xx OR Produ��e�if': �'�
Personally Known xx OR ProduliV��i
Type of Identification _* : 2oembar 7s?�9 c
Type ofIdentificationentification 0 los
Produced�`oe
• 936050 ;oQ.
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(Signature of Notary Public- State of Flo rid`.y t/C, s,, O( t
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(Signature of Notary Public- State o j� Tra�,ysx,:
q.A06gUC,•S••...
Commission No. FF936050 (Seal)
Commission No. FF936050 //�J�(J1It11\\\\
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17