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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED )© Date: Permit Number: li-SciS " o I 1 1111 PENN= 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 INPROUEMENT LOCATION: Address: 6807 NW FROST TERRACE, PORT ST. LUCIE Legal Description: OLEANDER PINES BILK 1 LT 12 Property Tax ID#: 3415-705-0013-000-1 Lot No. Site Plan Name: Block No. Project Name KANE OF—J Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: TEAR-OFF SHINGLE. RE-NAIL DECK. INSTALL NEW SHINGLE ROOF SYSTEM OVER#30 FELT UNDERLAYMENT (37SQ./5:12P) CONSTRUCTION INFORMATION: _ Additional work toe nertormed under tispermit—check all that appy: ❑HVAC Gas Tank Gas Piping 1:1MGenerator Shutters Windows Doors 11 Electric 0 Plumbing Sprinklers Roof Total Sq. Ft of Construction: 3700 - S Ft.of First Floor: Cost of Construction:$ 8,680.00 Utilities:Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name STEVEN&DIANE KANE Name: KYLE WHITE Address:5139 E.ASHELFORD DRIVE Company: J.A.TAYLOR ROOFING, INC. City: BYRON State:_ Address: 302 MELTON DRIVE Zip Code: 61010 Fax: City: FORT PIERCE State: Phone No.618-719-4352 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: karenfortaylor@aol.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 CONSTRUCTION LIEN'LAW INFORMATiON:` DESIGNER/ENGINEER: x—Not Applicable MORTGAGE COMPANY: AH x Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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 lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/ essee Signature of Contracto /License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF SAINT LUCIE COUNTY OF SAINTLUCIE The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 6TH day of MAY 20LLA5J by this 6TH day of MAY 20-Mby KYLE WHITE KYLE WHITE (Name of person ac k owledging) (Name of person acknowledging) (Signature of Notary Public-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 X01111,,, Commission No. FF116637 (Seal) Commission No. 11115637 _��"•�; 5 C AREN S. NIELSE ft �•';:«��;;; KAREN S. NIELSE ;y� M mCoission tt FF03 115 m #FF 115637 „"1N June 12, Z018'r Revised 07/15/2014 1;•,, M commission Expires ' June 12, 201 a REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED