HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: J' I S 1 Permit Number:
.. -- SCANNED RECEI D
• St. Lucie Countv MAR 31 2015
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 X
PERMIT APPLICATION FOR: Roof II
PR OPOSED.INQROVEMENT LOCATION:
Address: 3300 TWIN LAKES TERRACE, UNIT #201, FORT PIERCE
Legal Description: LAKESHORE VILLAGE OF MEADOWOOD PHASE I BLDG 3006 UNIT 201 (OR 792-347:
Property Tax ID #: 1327-704-0067-000-5 Lot No.
Site Plan Name: Block No.
Project Name: CAMPBELL RESIDENCE J
Setbacks Front Back: Right Side: Left Side:
)MILED DESCRIPTION OF WORK:
REROOF "FLAT DECK ONLY" INSTALL JM 3-PLY APP MODIFIED BITUMEN ROOF SYSTEM.
CONSTRUCTION] N FORMATION:
AriIf itinna wnTnr tnnio nprtnrmpri iinrlprthiq norm it— rhprk, nil t nt nn i it
EIHVAC Gas Tank ❑Gas Piping
11 Electric 0 Plumbing Sprinklers
Total Sq. Ft of Construction: 700
Cost of Construction: $ $7,800.00
Shutters ❑ Windows/Doors
Generator W1 Roof
S Ft. of First Floor: _
Utilities:Sewer Septic
Building Height:
ON- NER/LESSEE:_
CONTRACTOR:
Name YOLE CAMPBELL
Name: KYLE WHITE
Address:1919 BOSTON ST SE APT B219
Company: J. A. TAYLOR ROOFING, INC.
City: GRAND RAPIDS State: _
Zip Code: 49506 Fax:
Phone No.772-882-8334
Address: 302 MELTON DRIVE
City: FORT PIERCE State:_
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: karenfortaylor@aol.com
State or County License: CCC1325895
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION':
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
X Not Applicable
Name: T.C.B.E.,INC.
Name:
Add res5: 7205 ELYSE CIRCLE
Address:
City: PORTST.LUCIE State: FL
City:
State:
Zip: 34552 Phone: 772-46rr5509
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
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 Assocation rules, bylaws or antl 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 property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or, an attorney before
Signature of Owner/ Agent/ Lessee
STATE OF FLORIDA
COUNTY OF SAINTLUCIE
The forgoing instrument was acknowleclgd before me
this 19TH day of MARCH 20by
KYLE WHITE
Known x
Type of
Commission No. FF1
Revised 07/15/2014
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF SAINTLUCIE
The forgoing instrument was acknowledged before me
this 19TH day of MARCH 2O[L;Sby
KYLE WHITE
(Name of person
-State of Florida ) (Signature of Notary Public- State of Florida )
OR Produced Identification Personally Known x OR Produced Identification
Iced Type of Identification Prodei e d_
K ��� S. NIELSEN ommission No. FF71s637 ; Co3} S. NIELSEN
;o mis'sion R FF 11 ires = •2 on N FF 175637
de My Commission Expires
My Commission Expires
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