HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
SCANNED Permit Number: A lQiEWE6lob
BY
St. Lucie Cot,— 3� 10,
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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 Residential XX
PERMIT APPLICATION FOR: Roof III
Address: 5812 SILVER OAK DRIVE, FORT PIERCE
Legal Description: INDIAN RIVER ESTATES -UNIT 06 - BLK 21 LOTS 18 AND 19
Property Tax ID #: 3402-607-0221-000-1 Lot No.
Site Plan Name:
Project Name:
SHORT/REROOF
Setbacks Front Back: Right Side: Left Side:
Block No.
TEAR OFF SHINGLE, RENAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP METAL
PANEL ROOF SYSTEM (FL#17443.1) OVER OWENS CORNING WEATHERLOCK TILE & METAL
SELF -ADHERED LINDERLAYMENT (FL#9777.7).
Auwuonai worK Lo oe errormeu unuer cnis Perron—cnecK an apply:
11HVAC Gas Tank Gas Piping _ Shutters ❑ Windows/Doors
Electric OPlumbing []Sprinklers Generator Roof 6/12 Roof pitch
Total Sq. Ft of Construction: 3,200 S Ft. of First Floor: 2,112
Cost of Construction: $ 13,000 UtilitiesSewer OSeptic Building Height: 1 STORY
`OWNER}JLE$SEE
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GONTRAC7OR
Name JOSEPH SHORT III
Name: KYLE WHITE
Address: 5812 SILVER OAK DR
Company: J.A. TAYLOR ROOFING INC
City: FORT PIERCE State: FL
Zip Code: 34982 Fax:
Phone No. 772-464-2404
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.
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�tJFPL€MEN'fAi CONSTRUCfiO � LIENr SIN IN�ORMATI®N �
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DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY:
Name:
WM
_ of Applicable
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ of 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 failu to Record a Notice of Commencement may result in your p ing twice for
improvements to your pr Notice of Commencement must be recorded and po o he jobsite
before the first inspe . If intend to obtain financing, consult with lender or torn before
commencingwo r record' our Notice of Commencement.
r
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTYOF SrLUCIE
The forgoing instrument was acknowledged efore me
The forgoing instrument was acknowledged efore me
zsTH day OCTOBER by
this 25TH day of OCTOBER 2D) by
this of 2D
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
Produced
(Signature of Notary Public -State of Florida)
(Signature of Notary Public -State of Florida)
NADINEMANRESA
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Commission No. GcasszoB ®,rq ISeommisslon#1313355203
Commission No. ccasszos (SHDINEMANRESA
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' Expires November 15,202
. .. Commission # GG 355203
0491oi IF BBordWTBmBWpelNotarySwlce
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�y Expires November15,2023
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Rev.8/2/17