HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: — 5• ( 5• Iq SCANNED Permit Number: O
�� J4 BY
�$.P_ucko County RECEIVED
Building Permit Application MAY 15 2019
Planning and Development Services
Building and Code Regulation Division
ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xx
PERMIT APPLICATION FOR: Roof
Address: 8205 BAYARD ROAD, FORT PIERCE
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Fr
LAKEWOOD PARK - UNIT 5 - BLK 55 LOT 18
1301-605-0370-000-8
GRASSLEY/REROOF
Back: Right Side: Left Side:
Lot No.
Block No.
TEAR OFF SHINGLE AND MODIFIED, RENAIL DECK. INSTALL NEW JA TAYLOR EDGE-LOC
METAL PANEL ROOF SYSTEM (NOA#18-1023.07) OVER OWENS CORNING WEATHERLOCK
TILE & METAL (FL#9777.7) SELF- ADHERED UNDERLAYMENT - 35sq. ON FLAT SECTION
11HVAC 0 Gas Tank
11Electric OPlumbing
Total Sq. Ft of Construction: 4,500
Cost of Construction: $ 22,710
Piping ❑_Shutters ❑Windows/Doors
nklers Generator Z Roof 5/12 Roof pitch
S Ft. of First Floor: 2,946
Utilities: Sewer 0 Septic
Building Height: 1 STORY
OWNER/LESSEE: �
CQNT A++�OR:
Name BONNIE GRASSLEY
Name: KYLE WHITE
Address: 8205 BAYARD ROAD
Company: J.A. TAYLOR ROOFING INC
City: FORT PIERCE State:, FL
Zip Code: 34951 Fax:
Phone No.772-828-9243
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4040
E-Mail: BONNIE@ECTFL.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.
�SUPPLENI NTAL�CONSTEtUCl'IOR]�LIENIAINF.ORMATiON
�
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DESIGNER/ENGINEER:` _Not Applicable
Name:
MORTGAGE COMPANY: _
Name:
otApplicable
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
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 pr erty. A Notice of Commencement must be recor Oind posted on the jobsite
before the first inspe ' . If pu intend to obtain financing, consult wit nrrpr an attorney before
cammencine wor recor a vour Notice of Commencement. / I
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST LUCIE
COUNTY OF snucie
The forgoing instrument was acknowledge efore me
The forgoing instrument was acknowledge efore me
13TH day Y 20� by
this 13TH day of m y 20this
by
Y of
KYLE WHITE \\\\\IIIII IIIII�I�`�l
KYLE WHITE -
Name of person making staternoiM� ..`5...:X. %%✓
Name of person making
OR Prod Cement w\\\ p M�9• /4�
Personally Known OR Producedi Id e ip�iiF �
Personally Known w WD %
Type of Identification _; o°em '�0 9m ; s
•�2 �N•
Type of Identification . \yµ\SSION q•H ��
b2f lSYA�
Produced
.6�
Produced
Zy`. n"FF936050
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_
••.&'fMzdrhN;,�e:•.^ Q �"
#FF 936050
(Signature of Notary Public -State of Flori �✓(/��fPjlSTAltllllitµ\N
Signature of Notary Public- State of FloriEF�%"�-pG •,No�.rys;,. w\o
Fw
CIS
Commission No. FF936050 (Seal)
Commission No. FF936050 Sea
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17