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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr ALL APPLICABLE INFO MLAST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: l 4 ��✓� Permit Number:RM o co f, FA Building Permit Application s Planning and Development Services etp°�© CANNED Building and Code Regulation Division �� �r BY 2300 Virginia Avenue, Fort Pierce FL 34982 @ C'pUn Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XX tv PERMIT APPLICATION FOR: Roof PROPOSED IIVIPROUEMENT LOCATION Address: 5514 PALMETTO DRIVE, FORT PIERCE Legal Description: INDIAN RIVER ESTATES - UNIT 06 - ELK 22 - LOT 16 AND N 1/2 OF LOT 17 Property Tax ID N: Site Plan Name: Project Name: Setbacks Front 3402-607-0241-000-7 WOLKOWSKY/REROOF Back: Right Side: Left Side: DETA'ILED'DESCRIPTIQN"OF WORK Lot No. Block No. TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW JA TAYLOR ROOFING EDGE-LOC METAL PANEL ROOF SYSTEM OVER OWENS CORNING SELF -ADHERED UNDERLAYMENT. CON STRUCT,ION'1NF'ORMATION �r LJHVAC I_ I Gas Tank ❑Electric OPlumbing Total Sq. Ft of Construction: 3,700 Cost of Construction: $ 27,545 Piping ❑_Shutters ❑Windows/Doors nklers ❑ Generator W1 Roof 6/12 Roof pitch S Ft. of First Floor: 3,744 Utilities:llSewer ❑Septic Building Height: 1 STORY OVi/NER/LESSEEc , . ry u CONTRACTOR' Name SAM WOLKOWSKY Name: KYLEWHITE Address:5514 PALMETTO DR Company: J.A. TAYLOR ROOFING INC City: FORT PIERCE State: FL Zip Code: 34982 Fax: Phone No. 772-577-1234 Address: 302 MELTON DRIVE City: FORT PIERCE State: FL Zip Code: 34982 Fax: 772-468-8397 Phone No. 772-466-4040 E-Mail: SWOLKOWSKY@AOL.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 LAW INFORMATION: DESIGNER/ENGINEER: 1211otApplicable MORTGAGE COMPANY: _ Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Z Zip: Phone: FEE SIMPLE TITLE HOLDER: �ot Applicable BONDING COMPANY: L.NWot Applicable Name: Name:_ Address: Address: City: City:_ Zip: Phone: Zip: 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 prope . A Notice of Commencement must be recorded a d posted on the jobsite before the first inspection yo� ntend to obtain financing, consult with lend or an attoy��y before commencinE work or r ordinp/(nr Notice of Commencement. Signatur of Own ssee/Con ractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF STLUCIE COUNTYOF STWCIE The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged efore me this 11TH day of DECEMBER 20A by this 11TH day of DECEMBER 2Q by KYLE WHITE KYLE WHITE Name of on making I llllh'' �Ui ma Name of RinPg duce! �N gfyRFs/��V/ x PersonallyKnown xx OR Produced `jtf�\ I1q xrson Personally Known '_` Type of Identification �` @°os�1 Identification_a..]I4i�TO+j,�,pser't�ShN'�o'N.o9�-�: Produced 1115 Produced N : %y, §FF 936050 8FF 936050 o Z f •. �i'IdedO4 (S gnature of Notary Public- State of Fi�Q�.•(��, S'"'�d�°y;%'���� (Signature of Notary Public -State of F pFF���� IC°STAS Commission No. FF936050 (]�KB�'ii\1��\\ \off\\\` Commission NO. FF836050 (Sea��llllltttt REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED •� Rev. 8/2/17