HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI ' ,
ALL APPLICABLE (INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: .1) "-,y I q Permit Numbed '?Qa�0'3 7
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Building Permit Application p M4T o8 1 B of SCANNI
Planning and Development Services eS 1tti, BY
Build
Regulation Division
de
23001 Vng ii giniaAando Avenue, Fort Pierce FL 34982 f L"qe coy" eot St. Lucie C,
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xx
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 352 BRIDLEWOOD WAY
Legal Description: 10 35 39 N 1/2 OF SW 1/4 OF NE 1/4 OF SE 1/4-LESS W 25 FT FOR RD R/W AS IN FIB 28-4
Property Tax ID #: 2310-413-0001-000-3
Site Plan Name:
Project Name: CODERRE/REROOF
Setbacks Front Back:
I DETAILED DESCRIPTION OF WORK: a
Right Side:
Left Side:
Lot No.
Block No.
TEAR OFF SHINGLE, RENAIL DECK. INSTALL NEW JAT 5V CRIMP METAL (FL#17443.1) ROOF
SYSTEM OVER 30#FELT UNDERLAYMENT . ON FLAT - INSTALL POLYGLASS MODIFIED ROOF
(FL#16564.1) OVER 1/8" TAPERED INSULATION ('W—(2I)I
CONSTRUCTION INFORMATION:
MUV, UU,IGI VVUIN LU UC
❑HVAC
CI IUI IIICU
Gas Tank
UIIUCI UII� PCIII IIL-611CL.R GII tJ0PJJ1y.
❑Gas Piping
❑Windows/Doors
_Shutters
❑Electric
OPlumbing
❑Sprinklers ❑Generator
Roof 4/12 Roof pitch
Total Sq. Ft of Construction: 1,800
S Ft. of First Floor: 1,200
Cost of Construction:
$ 10,100
Utilities:
Sewer
❑Septic
Building Height: 1 STORY
OWNER/LESSEE:
CONTRACTOR:
Name ALBERT E CODERRE
Name: KYLE WHITE
Address: 352 BRIDLEWOOD WAY
Company: J.A. TAYLOR ROOFING INC
City: FORT PIERCE State: FL
Zip Code: 34945 Fax:
Phone No. 772-626.2402
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772468-8397
Phone No. 772-466.4040
E-Mail:
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.
r• r
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:'
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: . _Not Applicable
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 or installation has commenced prior to the issuance of a permit.
no
re.
re the permit holder to build the subject structure
or and covenants that may restrict or prohibit such
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 the first inspection. If you intend to obtain financing, consult with lender or an attorney before
comm,eocing work or recording your Notice of Commencement.?
kJ14A_
a,, ME
Signaturog of Owner/ Lessee/Contractor as Agent for Owner
Sign ure of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OF STLUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this LsT day of MARCH . 20n by
this tST day of MARCH . 20a 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 Pose,, VALERIEJ DELGADO
Type of Identification
olrxr o
Produce a MY COMMISSION # GG 06327
Produced o�"�`j.".os�� VALERIEJDEL
T EXPIRES: May 14, 2021
n MY COMMISSION#
F iIpo Bonded Tluu Budget Notary
>t ' EXPIRES: May 14
e-F `
1`3Bonded Thm Budget No
(Signature of tary Public- a of Florida)
(SidWature of Notary Public-S to of Florida )
Commission No. GG063270 (Seal)
Commission No. GG063270 (Seal)
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Rev.8/2/17