HomeMy WebLinkAboutBUILDING PEMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED'
Date: 15 --,SCANNED Permit Number
BY
® St. Lucie County
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
PERMIT APPLICATION FOR: Roof
Address: 5203 PALM DRIVE, FORT PIERCE
Legal Description: INDIAN RIVER ESTATES - UNIT 07 - BLK 49 LOT 32
Property Tax ID #:
Site Plan Name:
Project Name:
3402-608-0334-000-9
GATESLREROOF
Setbacks Front Back: Right Side: Left Side:
In I
RECEIVED
APR 33 2019
ST. Lucie County, Permitting
Residential xx
Lot No.
Block No.
TEAR OFF SHINGLE, RENAIL DECK, INSTALL NEW JA TAYLOR ROOFING EDGE-LOC METAL
PANEL (NOA#18-1023.17) ROOF SYSTEM OVER OWENS CORNING WEATHERLOCK TILE &
METAL SELF -ADHERED LINDERLAYMENT (FL#9777.7).
❑HVAC Ii Gas Tank
11 Electric ❑ Plumbing
Piping II Shutters
nklers ❑ Generator
Windows/Doors
❑✓_ Roof 4/12 Roof pitch
Total Sq. Ft of Construction: 2,900 S . Ft. of First Floor: 2,136
Cost of Construction: $ 15,650 Utilities. — er ❑Septic Building Height: 1 STORY
OWNER LESSEE{
GONfRt117OR3Tr
Name CHARLES GATES & KRISTIN DAVIES
Name: KYLE WHITE
Address: 5203 PALM DR
Company: J.A. TAYLOR ROOFING INC
City: FORT PIERCE State: FL
Zip Code: 34982 Fax:
Phone No. 772-971-4899
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4040 ,
E-Mail: KDAVIES808@YAHOO.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.
SIJPPIMNfALCON TRUE I1LIENLWINORMATiQN:
.
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
of Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name:
of 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 paying twice for
improvements to your prope A Notice of Commencement must be recorded and poste on the jobsite
before the first inspec If L intend to obtain financing, consult with lender y+ t ey before
commencine wording vour Notice of Commencement.
Signature o wner/ Lessee/Contractor as Agent for Owner
Signature of Contras or License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 6TWCIE
COUNTYOF erLUCIE
The forgoing instrument was acknowledge efore me
The forgoing instrument was acknowledged before me
this 22NO day APRIL 20)9 by
this 22N0 day of APRIL • 211 by
of
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
Type of Identification
Produced XI%lill 111111411,
Produced
Oib�yat 152p 9F,°.
\' pxr 75"i •• �S.
(Signature of Notary Public -State of Flo0a ): g
ature of Notary Public- State offlout ) N
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Commission NO. FF936050 'i•• OFF
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.Commission No. FF 936050 �2'••(SdEIP36050 :,Q
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SUPERVISOR
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DATE
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DATE
COMPLETED
Rev.8/2/17