HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: Sa S—(0117
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
PROPOSED INPROVEMENT LOCATIO N
Address: 3635 S.25TH STREET (DETACHED OUTBUILDING)
Legal Description: 29 35 40 N 110'OF S 220'OF N 385'OF SE 1/4 OF SE 1/4 LYGE OF CANAL 29-LESS E 60' RD R/W
Property Tax ID#: 2429-441-0002-100-3 Lot No.
Site Plan Name: Block No.
Project Name[ RNOFF REROOF
Setbacks Front Back: Right Side: Left Side:
1Al
DETAILED DESCRIPTION OF WORK.
_(0 TEAR-OFF SHINGLE. RE-NAIL DECK. INSTALL NEW 5V CRIMP METAL PANEL ROOF SYSTEM OVER
SELF-ADHERED UNDERLAYMENT. (3SQ. / 5:12P)
CONSTRUCTION INFORMATION.
Additional work to be nertormed
. under this permit—check all appy:
❑HVAC Gas Tank Gas
0 Piping Shutters QWindows/Doors
11 Electric Plumbing Sprinklers _ enerator
W1 Roof
Total Sq. Ft of Construction: 300 SFt.of First Floor:
Cost of Construction:$ 2,050.00 Utilities:cnSewer Septic Building Height:
OWNER/LESSEE: ; CONTRACTOR:
Name MARC ARNOFF Name: KYLE WHITE
Address:3635 S.25TH STREET Company: J.A.TAYLOR ROOFING, INC.
City: FORT PIERCE State:FL Address: 302 MELTON DRIVE
Zip Code: 34981 Fax: City: FORT PIERCE State:FL
Phone No. 772-577-1903 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.
SUPPLEMENTAL CONSTRUCTIOR LIEN,LAWINFORMATION '
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.LUCIE State: FL City: State:
Zip: 34952 Phone: 772-466-5509 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
beforea first inspection. If you intend to obtain financing, consult with lender or an attorney before
comm "mring work or recording our Notice of Commencemen .
I*— I� R—i
Si nature of Owner/Agent/Lessee Sign re bf Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINTLUCIE COUNTY OF SAINT LUCIE
The forgoing instrument was acknowled ed before me The forgoing instrument was acknowledged before me
this 27TH day of APRIL 201L.0 by this 27TH day of APRIL 20M by
KYLE WHITE KYLE WHITE
(Name of per n ackno I dgi' g) (Name of pers cknowl 'd ing)
i
(Signature of Notary Pu lic-State of Florida) (Signature of Notary Public-State of Florida )
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF115637 ; KAREN S. N EQc�iUPtSissi NO. FF115 KAR�nda$ NIELSEN
commission#F 1 res ;P;P.." " `<<'., Comms io}#FF 115637
'• " ommissio Expires =; *= MY Commission Expires
� June 12, 2o18 Jun
Revised 07/15/2014
00
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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DATE
COMPLETED