HomeMy WebLinkAboutBUILDING PERMIT APPLICATION'or ` - 1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
SCANNED 1 g0 _
Date: 6Y Permit Number:
— -- -- -„ St. Lucie County
RECEIVED
Building Permit Application JUL 0 3 2010
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1SS3 Fax: (772) 462-1578 Commercial XX Residential
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address
5101 N HWY AIA, COMFORT STATION ON INLET
Legal Description: OCEAN RESORTS, CO-OP INC. 10 34 40 NE 1/4 OF SE 1/4 OF SW 1/4 AND NW 1/4 OF SW 1/4 OF SE 1/4
AND S 112 OF NW 1/4 OF SE 1/4 OF LY WLY OF MEAN HIGH WATER LI OF BLUE HOLE CREEKICOVE AND INDIAN RIVER, AND MORE
Property Tax ID #: 1410-502-0000-000-3 Lot No.
Site Plan Name:
Project Name
INLET COMFORT STATION/REROOF
Setbacks Front Back: Right Side: Left Side:
Block No.
TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW OWENS CORNING OAKRIDGE SHINGLE
ROOF SYSTEM (FL#10674.1) OVER OWENS CORNING WEATHERLOCK G (FL#9777.1) SELF -
ADHERED UNDERLAYMENT.
HaamonarworKtooe errormea unoerimsperina—cnecKaa
❑HVAC Gas Tank ❑Gas Piping
apply:
Shutters
❑ Windows/Doors
_
❑Electric ❑ Plumbing
❑Sprinklers
❑ Generator
W1 Roof 4/12 - Roof pitch
Total Sq. Ft of Construction: 1,600
5
Ft. of First Floor:
Cost of Construction: $ 7,740
Utilities:[]Sewer
❑Septic
Building Height: 1 STORY
[O;W,NER/LESSEE:
CONTRACTOR:
Name OCEAN RESORTS CO-OP INC
Name: KYLE WHITE
Address: 5101 N AIA
Company: J.A. TAYLOR ROOFING INC
City: FORT PIERCE State: FL
Zip Code: 34949 Fax:
Phone No. 508-274-5030
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.
.0 .;
SUPPLEMENTAL GONSTRU RION LIEN I AW3 INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
"ot Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
of Applicable
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 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 lende attorney before
commencingwor cordin our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OF SrLUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this zm+ day of JUNE .20 by
this 25TH day of JUNE
zo_ by
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 \NEMI......
Produced
i
o°VO,� ber 1520•°9�,••
`
ae
t 00 a�psr ]52oi°q •:
(Si nature of Notary Public- State of Ff6rid6) m•�
(Signature of Notary Public- State of Fl& it
° #FF 936050 ' Q
Commission No. FFs3soso ycc�agl �,, s;
�'7� !�, M.ed�hNg• oQ`
FF936050
Commission No.otarl
��RFF93fiD50 .•ae`
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
, I
Rev.8/2/17