HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABI.�// INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7 Permit Numb
MWN,.
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
Address:
101 AQUA RA DRIVE, JENSEN BEACH
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JAN 17 2019
Permitting Department
-St. Lucie_County, FL
Legal Description:
RIVER WATCH BLK 5 LOT 1 st: Lucie County
Property Tax ID #: 4511-815-0015-000-1
Site Plan Name:
Project Name:
GROSSMAN/REROOF
Setbacks Front Back: Right Side:
, DETAILED DESCRIPT10N`OF WORK -
Left Side:
Lot No.
Block No.
TEAR OFF TILE, RE -NAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP ALUMINUM
PANEL ROOF SYSTEM (30sq) OVER OWENS CORNING SELF -ADHERED UNDERLAYMENT. ON
FLAT PORTION INSTALL POLYGLASS (W-170) MODIFIED BITUMEN ROOF SYSTEM (2sq)
CONSTRUCTION 1NFORIVIATION: - -
OHVAC LJ Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction: 3,200
Cost of Construction: $ 25,300
pernui —aiccrc du
dppry:
❑
Gas Piping
_
Shutters
Windows/Doors
Sprinklers
E]
Generator
W1
Roof
6/12
Roof pitch
S . Ft. of First Floor: 2,335
Utilities:Sewer[]Septic Building Height: 1 STORY
OWNER/LESSEE:- _
CONTRACTOR:
Name MARILYN GROSSMAN
Name: KYLE WHITE
Address: 24 W HIGH POINT RD
Company: J.A. TAYLOR ROOFING INC
City: STUART State: FL
Zip Code: 34996 Fax:
Phone No. 772-678-6478
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Cade: 34982 Fax: 772-468-8397
Phone No. 772-466-4040
E-Mail: JULEMARI@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:
Name:
t4t Applicable
MORTGAGE COMPANY:
Name:
_ of Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_'I'-flot Applicable
BONDING COMPANY:
Name:
_ of 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. ty. A Notice of Commencement must be recorded and ee l on the jobsite
before the first ins n. f you intend to obtain financing, consult with lend n at/tfdr/I-iey before
commencing or reco ne vour Notice of Commencement.
Signature o wrier/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 6TLUcIE
COUNTY OF STLOQE
The forgoing instrument was acknowledge before me
The forgoing instrument was acknowledgedbefore me
this 16TH day of JANUARV 20 by
this 16TH day of JANUARY 2O by
KYLE WHITE ttlllllll
KYLE WHITE
Name of person making stateme pDl M ii�4
Name of person making statement`�\\W%II1111111/111�
Personally Known � OR Produce �entcY�LttfBtTip�.�Lj�'`.�
Personally Known xx OR Produced�}
Type of Identification = * ��J osemhorty. F.�6
Type of Identification � :, o�MISSIO,y'•., �
Produced'Produced
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oter lsA�•, s
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(Si nature of Notary Public- State of Flori�ajr TAT `a"
(Sign ture of Notary Public- State of FIC B jeC/nyra,ys..0\
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Commission No. FF936050 (Seal)
Commission No. (���tI1111Arq
FF936050
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17