HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / I
Date: � • - I 19 SCANNED Permit Number: 19 Q �J - 6 `I4 U
BY
St. Lucie County RECEIVED
Building Permit Application MAY 31 9niQ
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: 140 N NARANJA AVENUE, FORT PIERCE
Legal Description: RIVER PARK - UNIT 4 BLK 40 LOT 35
Property Tax ID #: 3419-530-0257-000-9
Site Plan Name:
Project Name: BROWNLREROOF-
Setbacks Front Back: Right Side: Left Side:
ST. Lucie County, Permitting
Residential xx
Lot No.
Block No.
FLAT ROOF ONLY: TEAR OFF MODIFIED ROOF, RENAIL DECK. INSTALL NEW POLYGLASS
(W-61) MODIFIED BITUMEN ROOF SYSTEM (F�)
E1HVAC Gas Tank Gas Piping ❑_ Shutters 1:1Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator W1 Roof Roof pitch
Total Sq. Ft of Construction: 700 S Ft. of First Floor: 1,736
Cost of Construction: $ 4,950 Utilities:Sewer Septic Building Height: 1 STORY
OWNERJCESSEE A10,f
CONTRACTOR
Name VICTORIA BROWN (TR)
Name: KYLE WHITE
Address: 1626 90TH AVE
Company: J.A. TAYLOR ROOFING INC
City: VERO BEACH State: MA
Zip Code: 32966 Fax:
Phone No. 772-201-7453
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4640
E-Mail: VICTORIAJBROWN@GMAIL.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 CONST{tUGTION LIEN LA1M'
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DESIGNER/ENGINEER: _&ACot Applicable
Name:
MORTGAGE COMPANY:
Name:
C_Naf p licable
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 pertotice of Commencement must be recorded an osted oobsite
before the first ins on. If yo 1I tend to obtain financing, consult with lende an attorne ore
commencin r recordin ur Notice of Commencement.
Sign re of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST WCIE
COUNTY OF ST WCIE
The forgoing instrument was acknowledge efore me
The forgoing instrument was acknowledged before me
zsRo "
this 23RD day of my by
this day ofy 20 jby
KYLE WHITE\\1111EIIt0i///
KYLEWHITE
Name of person making statemenL�����E ° C94 �ed
Personally Known xx OR Produced r��i�iNf85
1�o
Name of person makingstatement\\11111lIIII//
Personally Known xx OR Produce�,�rt�„f�aii�l�/fi>.
Type of Identification ; o� yx� R
F � N .
m
GYP e of Identification
s9
Produced - o a
i*roduced •°'o�e�hes/�N '%
�-k ° F g3E050
_ >f ° 2 •�� m
(Signature of Notary Public -State of Florida
(Sligo Lure. of Notary Public- tate o s c`%aa So.
Q<w\
Commission No. FFsasoso (Seal)
Commission No. FF936050
ii111i\
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Rev.8/2/17