HomeMy WebLinkAboutBUILDING PERMIT APPLCATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I ��� �rC SCANNED Permit Number: T1� -I ' Ouao
BY
• St. Lucie County
Building Permit Application RECIEMD
Planning and Development Services SEP,2.q 2019
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 PennittIn9 Department
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential )6k• Lude county
PERMIT APPLICATION FOR: Roof
■U%t9J:L6N1RI'm IAiRIoielYJgPAla►a®keIffG®®Ls,►
Address: 1215 HARTMAN ROAD, FORT PIERCE
Legal Description: 18 3540 FROM NE COR OF SEC RUN S ALG E SEC L1 1899.22 FT FOR POB, TH 88 DEG 45 MIN W 265 FT
TH S 209 FT, TH N 88 DEG 45 MIN E 120 FT, TH N 70 FT, TH N 88 DEG 45 MIN E 145 FT, TH N 139 FT TO POB-LESS E 25 FT
Property Tax ID #: 2418-141-0005-000-8
Site Plan Name:
Project Name: GELETY/REROOF
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Lot No.
Block No.
TEAR OFF ROLL ROOFING, RE -NAIL DECK. INSTALL NEW POLYGLASS FLAT ROOF SYSTEM.
TAPERED (W-58) 37SQ. NON -TAPERED (W-140) 6SQ
1-1 Electric 0 Plumbing ❑Spr
Total Sq. Ft of Construction: 4.300
Cost of Construction: $ 34,860
ng 11Shutters Windows/Doors
!rs Generator [z] Roof 0/12 Roof pitch
S Ft. of First Floor: 5,283
Utilities:CnSewerOSeptic Building Height: 1 STORY
OWNER/LESSEE:
CONTRACTOR:
Name KAREN GELETY
Nil, KYLE WHITE
Address: 2507 LAZY HAMMOCK LN
Company: J.A. TAYLOR ROOFING INC
City: FORT PIERCE State: FL
Zip Code: 34981 Fax:
Phone No. 772-332-6783
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4040
E-Mail: KSGELETY@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 CONSTRUCTION
LIEN
LAW IN.,
ORMATIO --
DESIGNER/ENGINEER:
Name:
of Applicable
MORTGAGE COMPANY _ of Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
of Applicable
BONDING COMPANY: of 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, 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 yo property. A Notice of Commencement must be recordedg,4nd posted on the jobsite
before the first i ectj�jl. If you intend to obtain financing, consult with I r orttorney before
commenci rk or a ordine your Notice of Commencement.
i
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signat re of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTYOF STLUCIE
The forgoing instrument was acknowledged efore me
The forgoing instrument was acknowledged efore me
this 25TH day of SEPTEMBER 2812by
this 25TH day of SEPTEMBER 2Q�by
---FFF���
KYLE WHITE
KYLE WHITE}nlll 4r,..
Name of person making statement X\q\IU11tll1lllpN�
Personally Known xx OR Produced Ic�i r3 i (: tlR
Name of person making statement
Personally Known xx OR Produced Ide�tl a�e
Type of Identification•,\s5I0N •••. �
O°
Type of Identification
°
obi•
roducedProduced P
#FF 936050
(S' nature of Notary ublic-State of Flori����q/`p rrbST?-W , ,
(Si nature of Notary Pt blic- State of Florida )'�i,e � s�'i`1111`:�o�<a
Commission No. FF936050 (Sealy//lifllllllll:\�"
Commission No. FF936050 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
- - ---
-COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
-REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17