HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: I SOS_ Q 5a,4
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
PyROFCOSED INI?ROVEMEN LOCATIC31`I re rirE �Gr„ -,
Address: 5773 STARCHER AVE., FORT PIERCE
Legal Description: HENNING S/D AN UNRECORDED PLAT IN SEC 12-35-39 W 1/2 OF LOT 1
Property Tax ID#: 2312-801-0001-010-3 Lot No.
Site Plan Name: Block No.
Project Name: HARRELL REROOF (SFR).
Setbacks Front Back: Right Side: Left Side:
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DEQ{LED DESR%IPTION 01= WORK
t *"fix x r! t °.anrY ` a rt7-yd ifn,,m, ti '
TEAR-OFF SHINGLE. RE-NAIL DECK. INSTALL NEW 5V CRIMP METAL PANEL ROOF SYSTEM OVER
#30 FELT UNDERLAYMENT. (34SQ./6:12P). INCLUDES FLAT DECK. INSTALL JOHNS MANVILLE 3-PLY APP
MODIFIED BITUMEN ROOF SYSTEM. (2SQ./FLAT)
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CQ'NSTRUCT{fJN {NFORMITION pu7 a ; h w
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Additional wor toe nertormed under this permit—c ec a appy:
❑HVAC Gas Tank Gas PipingMGenerator
Shutters ❑Windows/Doors
0 Electric 0 Plumbing Sprinklers r Roof
Total Sq. Ft of Construction: 3600 S . Ft.of First Floor:
Cost of Construction:$ 9,860.00 Utilities: Sewer[]Septic Building Height:
ONR/LESSE
WNW
Name
Name SHELBY&RICHARD HARRELL Name: KYLE WHITE
Address:5773 STARCHER AVE. Company: J.A.TAYLOR ROOFING, INC.
City: FORT PIERCE State:FIL Address: 302 MELTON DRIVE
Zip Code: 34947 Fax: City: FORT PIERCE State:FL
Phone No. 772-216-3613 Zip Code: 34982 Fax: 772-468-8397
E-Mail: Phone No. 772-466-4040
Fill in fee simple Title Holder on next page(if different E-Mail: karenfortaylorQaol.com
from the Owner listed above) State or County License: CCC1325895
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SU1��?IEMENI'AL CONSTRU T10N IIEI� LAW INF
. ..
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: T.C.B.E.,INC. / HARVEY KOEHNEN Name:
Address:7205 ELYSE CIRCLE Address:
City: PORTST.LLICIE State: FL City: State:
Zip: 34952 Phone: n2-466-5509 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 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 len er or an attorney before
commencing workpr recording our Notice of Commencement.
el
Signature of Ow%/ ent/Lessee Signature of Contractor/License Holder
4
STATE OF FLORI STATE OF FLORIPJk
COUNTY OF .L�g �,C_ COUNTY OF - WCAL,
The forgoing instrUlnent,was acknowledged before me The forgoing instr ment was acknowledged before me
this l.L� day of 20by this JLo day of 20_W by
klq le UJe 2 A P.
(Name of person acknowledgg) (Name of person acknowl dging)
1
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
.•`•:r%'""•. K S. NIELSEN Commission No. "::""'•�
Commission No. r:• . , �'i . (�C'Al EN S. NIELSEN
_* �? Commission# FF 115637 * Commission#FF 115637
y �s My Commission Expires ao, My Commission Ex
%�,,,,,,•,r• june ''��,°;���•`` June 12;.2018
Revised 07/15/201
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED