HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / 9 /_ 0
Date ]� %� Permit Num e --- --
LA
Building Permit Applicatior JAN 3 0 2019
Planning and Development Services Permitting Department
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL
Phnna-177714FJ-1SSq Fax-17791469-157R Commercial Residential
PERMIT APPLICATION FOR: Roof BY
PROPOSED IMPROVEMENT LOCATION':.
Address: 1401 PARKLAND BLVD, FORT PIERCE
Legal Description: TOMILINSON'S UNRECORDED PLAT OF PART OF LOTS 215 AND 216 IN SEC 9-36-40 LOT 1
Property Tax ID #:
Site Plan Name: _
Project Name: _
Setbacks Front
3409-705-0001-000-5
ROCHESTER/REROOF
Back: Right Side: Left Side:
'-DETAILED DESGRIPTION`OF W'ORK: a
Lot No.
Block No.
TEAR OFF SHINGLE AND ROLL ROOFING, INSTALL NEW JA TAYLOR 5V CRIMP METAL PANEL
ROOF SYSTEM OVER 30# FELT UNDERLAYMENT (33sq). ON FLAT PORTION (4sq) INSTALL
POLYGLASS MODIFIED BITUMEN ROOF SYSTEM (W-170).
I.CONSTRUCTION'INFORMATION:
LLHVAC L. 1 Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction: 3,700
Cost of Construction: $ 14,260
JCI Il111—UIJU.K ell apply.
Sas Piping _ Shutters ❑ Windows/Doors
Sprinklers Generator W1 Roof 6/12 Roof pitch
S Ft. of First Floor: 2.290
Utilities:Sewer E]Septic Building Height: 1 STORY
•CONTRACTOR:
Name LEWIS & MELINDA ROCHESTER
Name: KYLE WHITE
Address: 3157 SW FARMBROUGH ST
Company: J.A. TAYLOR ROOFING INC
City: PORT ST LUCIE State: FL
Zip Code: 34982 Fax:
Phone No.772-985-3935
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4040
E-Mail: LEWISMD@STBERNADETTESLW.ORG
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:
Applicable
MORTGAGE COMPANY:
Name:
—ILof t Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not 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 aging twice for
improvements to your erty. A Notice of Commencement must be recorded an d on the jobsite
before the first ins for . f you intend to obtain financing, consult with lender a rney before
commencing or rec r ing your Notice of Commencement.
Signature o Owner/ lessee/Contractor as Agent for Owner
Signature o Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OF STLUCIE
The forgoing instrument was acknowledgeAbefore me
The forgoing instrument was acknowledged before me
this 28TH day of JANUARY 20 by
this 28TH day of JANUARY
261a by
KYLE WHITE
KYLE WHITE
Name of person making statement
Name of person making
statement
Personally Known xx OR Produced Identification
Personally Known xx OR Produced Identification
Type of Identification 111111l
Type of Identification
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Rev. 8/2/17