HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _n' au\ Permit Number:
SCANNED
„ + BY
St, Lucie County SEP 2 4 2019
Building Permit Application IT. W01County, Permitting
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 Residential xx
PERMIT APPLICATION FOR: Roof
PR $)P_- SEP IMPROVEMENT LOCAr. TION<
Address: 5308 HICKORY DRIVE, FORT PIERCE
Legal Description: INDIAN RIVER ESTATES - UNIT 07 - BLK 52 LOT 20
Property Tax ID #: 3402-608-0460-000-1
Site Plan Name:
Project Name: MOGE/REROOF
Setbacks Front Back: Right Side: Left Side:
Lot No.
Block No.
TEAR OFF SHINGLE, RENAIL DECK. INSTALL JA TAYLOR ROOFING 5V CRIMP METAL PANEL
ROOF SYSTEM (FL#17443.1) OVER OWENS CORNING WEATHERLOCK TILE & METAL
(FL#9777.7) SELF- ADHERED UNDERLAYMENT, REPLACE SKYLIGHT.
❑ Windows/Doors
0 Roof 4/12
Total Sq. Ft of Construction: 2,200 S . Ft. of First Floor: 1,008
Cost of Construction: $ 8,950 Utilities:Sewer Septic Building Height: 1 STORY
[QWNER/,LESSEE:
CONTRACTOR:
Name SANDRA MOGE
Name: KYLE WHITE
Address: 5308 HICKORY DR
Company: J.A. TAYLOR ROOFING INC
City: FORT PIERCE State: FL
Zip Code: 34982 Fax:
Phone No. 772-216-0586
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4040
E-Mail: SANDRAMOGE@COMCAST.NET
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 GONSTRill 3(lN ill LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ of Applicable
MORTGAGE COMPANY:
Name:
_CtNot Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
Jot 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 p y. A Notice of Commencement must be recorded posted on the jobsite
before the first i on.j� ou intend to obtain financing, consult with len r attorney before
commenci o or recoidlne your Notice of Commencement.
Signat re of Owner/ Lessee/Contractor as Agent for Owner
Signatu of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STwaE
COUNTYOF STWCIE
The forgoing instrument was acknowledged -before me
this 16TH day SEPTEMBER 2p 1'1 by
The forgoing instrument was acknowledged efore me
this 18TH day of SEPTEMBER ZQ by
of ��----ii
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
+\"ttpll;lll1/711!!r
oduced
Produced
\+++PptNEMAA/9F`cy
°\OthiSSlo,Y°
a°�=emhar 15 o�A9 •
w BSl7o�E/q`9 /
m •
¢m ?�. N
Sig ature of Notary Public -State oiFic' Tida I�� =
(Si nature of Notary Public- State of db
-z FF 936050
a p
Commission No. FF936050 �.9,4�Tj1de�11\N;ys; QUA-.
ijf✓'!l
1 SFF 936050 F
FF936050 Zo��e Q�
Commission No. :
'fill'ol�o`,Aw
��I�BC,
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
i
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17