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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ^O© ' Date: i-' Aluno� along -IS Permit Number: 01w/, AS a3NNVJS Building Permit Application A 0, �a2 Planning and Development Services ��'i�, p �G� Building and Code Regulation Division ��c°gQ- 'tom 2300 Virginia Avenue, Fort Pierce FL 34982 e o {y Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Res idK, l 4W PEA PERMIT APPLICATION FOR: Roof �PRQPOSED IMPR®�U�EME�NT L70CATI®�Nc� Address: 2105 OAK DRIVE, FORT PIERCE (FORT PIERCE INLET STATE PARK) Legal Description: REV PL OF FORT PIERCE SHORES - UNIT 5 - BLK 43 LOT 5 Property Tax ID #: 1436-602-0041-000-9 Site Plan Name: Project Name: INLET PARK/REROOF Setbacks Front Back: Right Side: Left Side: Lot No. Block No. TEAR OFF ROLL ROOFING, RENAIL DECK. INSTALL POLYGLASS (W-73) MODIFIED BITUMEN ROOF SYSTEM (FL#1654-R24) ON FLAT PORTIONS OF ROOF ONLY 11 Electric 0 Plumbing QWindows/Doors 0 Roof o/12 Total Sq. Ft of Construction: 948 S Ft. of First Floor: 1,485 Cost of Construction: $ 7,980 Utilities:Sewer 11 Septic Building Height: 1 STORY m DOWNER/LESSEE: t CONTRA OR Name TR INT IMP TRUST FUND Name: KYLE WHITE Address: 3900 COMMONWEALTH BLVD Company: J.A. TAYLOR ROOFING INC City: TALLAHASSEE State: FL Zip Code: 32399 Fax: Phone No.772-519-0620 Address: 302 MELTON DRIVE City: FORT PIERCE State: FL Zip Code: 34982 Fax: 772-468-8397 Phone No. 772 466 4040 E-Mail: STEVEN.ElBL@FLORIDADEP.GOV 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 za o Lk It value of construction is 52500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: t Applicable Name: MORTGAGE COMPANY: t Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: JJ0t Applicable Name: 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 a 'ng twice for improvements to your perty. A Notice of Commencement must be recorded an steel on the jobsite before the first ins ion. If Au intend to obtain financing, consult with lender an at/t;Aey before commencing or record(nik your Notice of Commencement. Sign to wner/ Lessee tractor as Agent for Owner Signature of ontractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF STLUCIE COUNTY OF STLUCIE The forgoing instrument was acknowledg�efore. me j The forgoing instrument was acknowledge' efore me 26TH SEPTEMBER this 26TH day of SEPTEMBER 2p by this day of 20 _U 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 IdentificationType of _ PYpd ofIdentification wAEM ddentification Produced \,a\\\0;pINE�q�N<<oo` 9Fy `\\\\\\ q ,o F9' ` �o \ISISSioN ys t°q•, :P \!oISS/p! ��SGoet�6ar 7S tcfo �, o°°'Thar Si ature of Notary Public -State of FlorLil ijt° XFF93b050 " b1 ig ature o Notary Public- State of Florif}a'�:. �ggFFep936050 COmmiBSion NO. FF 936050 (J�¢ •• �k�SeNM�;,' �, `(:OmmI5510n NO. FF B36050 (�• Abs;ys- l�rrl!!!I //A• STATES \\ Nf1101\\\\\\\ �llllilllVIII11\\\\ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17