HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 `�` Permit Number: 5a1 d�1
r ,
• '�_ IIi�ED JUL.0 6
Bui ing 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 INOROVEMENT LOCATION:
Address: 5294 EBB TIDE WAY , FORT PIERCE (MQBILE�W,®ME)
Legal Description: OCEAN RESORTS COOPERATIVE SITE 50
Property Tax ID#: 1410-502-0050-000-8 Lot No.
Site Plan Name: Block No.
Project Name: PAU_LSEN+RERO®Flilll
Setbacks Front Back: Right Side: Left Side:
-0, �.
DETAILED DESCRIPTION OF WORK:
TEAR-OFF SHINGLE. RE-NAIL DECK. INSTALL NEW SHINGLE ROOF SYSTEM OVER SELF-ADHERED UNDERLAYMENT.
(600 SQ. / 3:12 P)
CONSTRUCTIgN INFORMATION. ° .
Additional work toe e orme under this permit—check a apply:
HVAC Ei Gas Tank Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator W1 Roof
Total Sq. Ft of Construction: 600 S Ft.of First Floor:
Cost of Construction:$ 1,434.00 Utilities:CnSewer Septic Building Height:
OWN'fRAESSEE: CONTRACTOR:
Name HOWARD&NANCY PAULSEN Name: KYLE WHITE
Address:842 PIRATES COVE LANE Company: J.A.TAYLOR ROOFING, INC.
City: FORT PIERCE State:FIL Address: 302 MELTON DRIVE
Zip Code: 34949 Fax: City: FORT PIERCE State:FL
Phone No. 518-527-0272 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: CCC 1325895
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
2015-07-06 20:18 j.a.taylor roofing 772 468 8397 >> P 1/1
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DESIGNER ENGINEER: x Not Applicable MORTGAGE COMPANY: 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 Count makes no representation that is granting a permit will authorize thedpermit holder to build the subject structure
which is In conflict with any applicable Home Owners Association rules,bylaws or an 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 frst inspection.If you intend to obtain financing,con It with lender or an attorney before
commdnciaR work or re/4rding your Notice of Commencem nt
5 gnat er Agent/Lessee S1 o hactor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINTLUGG COUNTY OF 5AINTI,UCI13
The forgoing instrument was acknowleftjpfore me The forgoing instrument was acknowledged before me
this 2 day of JuLY 20JL4J by this 2No day of JuLy 20Zby
KYLE WHITE KYriC WHITE
(Name of person acknowle ng) (Name of person knowl'dgl g
JI/JAA
(Si nature of No ary 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
FF115637 mission No. FF"6637 a;;::":";
Commission No. Ri",
REN S. NtELSE K S. NIELS6NComMlselon q FF 1166 7 �" Commission#FF 115637
My Commission ExpireeJune 12, 2018 "'""`"� juneRevised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED