HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: la� �� SCANNED Permit Number: kc\Oq-05SGa
BY
St. Lucie County RECEIVED
Building Permit Application SEP 2 4 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-x
PERMIT APPLICATION FOR: Roof
�.
P;lOOP®SED IfVIPROVEMENT LOCATION:
Address: 8150 HIDDEN PINES ROAD, FORT PIERCE
Legal Description: HIDDEN PINES ESTATES BLK A LOT 2
Property Tax ID #: 2323-701-0002-000-4
Site Plan Name:
Project Name:
Setbacks Fr
SMITH/REROOF
Back: Right Side: Left Side:
Lot No.
Block No.
TEAR OFF SHINGLE, RENAIL DECK. INSTALL NEW OWENS CORNING DURATION SHINGLE
(FL#10674.1) ROOF SYSTEM OVER OWENS CORNING WEATHERLOCK G (FL#9777.1) SELF -
ADHERED UNDERLAYMENT. ON FLAT PORTION POLYGLASSW-61 (FL#1654.1) MODIFIED
BITUMEN ROOF SYSTEM (7sa)
huw uVFld I WUIR w ue enoImeu unaeF uns permu—CneLK au apply:
11HVAC Gas Tank Gas Piping _ Shutters ❑ Windows/Doors
Electric OPlumbing []Sprinklers Generator Roof 6/12 Roof pitch
Total Sq. Ft of Construction: 4,100 S[�y —F—t.� of First Floor: 2,112
Cost of Construction: $ 19,490 Utilities: Sewer D Septic Building Height: 1 STORY
OWNEF2 /LESSEE:
CONTR (TOR:
,Name DONALD SMITH
Name: KYLE WHITE
Address: 8150 HIDDEN PINES RD
Company: J.A. TAYLOR ROOFING INC
City: FORT PIERCE State: FL
Zip Code: 34945 Fax:
Phone No.772-579-3108
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
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.
SUPPLEMENTAL@ONSTRU("fION LIEN LAVUINFORMATION>
DESIGNER/ENGINEER: of Applicable
Name:
MORTGAGE COMPANY: _ of Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ of 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.
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, 1 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 y. A Notice of Commencement must bAreco d and posted on the jobsite
before the first insf . I ou intend to obtain financing, consult er or an attorney before
commencingworkecor, i g your Notice of Commencement.
Signature o caner/ Lessee7Contractor as Agent for Owner
Signatu ontractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OF STLUCIE
The forgoing instrument was acknowledge fore me
The forgoing instrument was acknowledgpJ�{j�efore me
this 18TH day of SEPTEMBER ZQ 1 / by
���
this 18TH day of SEPTEMBER ZQ I "I by
�F
KYLEWHITE
_ KYLE WHITE
Name of person making statement��se\�E M 1111"
Personally Known xx OR Produced`�d`e t+`f•+�at,on AF�r �r�
Name of person making statement . S\NEphfjjRF 1iy��
Personally Known XX OR Produced Idenf�lc��ie .
�.QP�;dSSIOry�:
Type of Identification e
7s2oA��.°
Type of Identification : `o"��bxr 76Ai'•
Produced %� oe�yar
- Produced
° 4FF 936050
fFF 936050
(Signature of Notary Public -State of Florit(�'�"��B-/�;STASE���\`\'
(Sig ature of Notary Public -State of Florida f:•!.
J,P,�Ep`���a�
iC.
Commission No. (Seal�rr��Plllllli+\t"\
FF 936050
Commission No. (Seal).agl,p Fitti4tt�'
FF 93fi050
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17