HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:T'-t 1`J Permit Number:
RECEIVED JUN 24'20i5
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 IN;PROVEMENT LOCATION: of <<
Address: 5512 PINETREE DRIVE, FORT PIERCE
Legal Description: INDIAN RIVER ESTATES UNIT 1 BLK 8 LOTS 16& 17
Property Tax ID#: 3402-602-0283-000-8 Lot No.
Site Plan Name: Block No.
Project�Name PRINCE REFiO:OF` j
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION C}F 1tVORK
TEAR-OFF SHINGLE. RE-NAIL DECKING. INSTALL NEW 5V CRIMP METAL PANEL ROOF SYSTEM
OVER#30 FELT UNDERLAYMENT. (22 SQ. -2:12/3:12/12:12 Mansard)
INCLUDES FLAT DECK ON SIDE. INSTALL JOHNS MANVILLE 3-PLY APP MOD.BIT. ROOF SYSTEM. (9 SQ.)
CQNSTRUCTIO..N INFORMATION
�
,f
itiona work to be nertormpd un cert ispermit—checka appy:
HVAC Gas Tank Gas Piping _Shutters Windows Doors
Electric ❑ Plumbing Sprinklers Generator IZI Roof
Total Sq. Ft of Construction: 3100 SFt. of First Floor:
Cost of Construction: $ 11,850.00 UtilitiesInSewer Septic Building Height:
OWNER/LESSEE: re ; �CONTRACTOR: `�
Name ROBERT PRINCE Name: KYLE WHITE
Address:701 NE 12TH AVE. Company: J.A.TAYLOR ROOFING, INC.
City: POMPANO BEACH State:FL Address: 302 MELTON DRIVE
Zip Code: 33060 Fax: City: FORT PIERCE State:FL
Phone No.954-937-1947 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 CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: T.C.B.E.,INC 1 HARVEY KOEHNEN Name:
Address:7205 ELYSE CIRCLE Address:
City: PORT ST.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
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencin work or 4ecording your Notice of Commencement.
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Signature of Owner e /Lessee Signature of Contractor/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 16TH day of JUNE .20=by this 16TH day of JUNE ,20=by
KYLE WHITE KYLE WHITE
(Name of person nowled in } (Name of perso know) dgI g}
(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 Produ a of Identification Produced
4o"rY��',. KAREN S. NIELSEN
.Q FF115637 ""'V ,� S. NIELSEN
Commission No. FF115637 �' + I�,iSSion# FF 11563 C mission No. ,o ••,,�,,,,
co, � My Commission Expire E *__ Commission#FF 115637
' June 12, 2018 .
+gefisP`�`~ M Commission Ex it
June 12, 2018
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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