HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: . .l Permit Number:
Mel 14
RECEIVED
Building Permit Application
Planning and DeveloprnentServices SEP 15 2015
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 LOCATION
Address: 5205 MELVILLE ROAD
Legal Description: WHITE CITY S/D 03/36/40 FROM SE COR OF LOT 38 RUN W 16'TO POB,TH CONT W 101',TH N 120',THE 101',TH S 120'
TO POB-LESS TO ST LUCIE CO AS IN OR307-477&SHOWN IN PB 19-19(.028 AC) (MAP 34-03S) (OR 982-279)
Property Tax ID#: 3403-502-0066-000-7 Lot No.
Site Plan Name: Block No.
Project Name: 'S RN REROOF (SFR)
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.
(29SQ / 6:12P)
CQNSTRUCTION INFORIUTATION
Additionalwork to be nertormed under this permit-check m a app y:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
E]
Electric 0 Plumbing Sprinklers FIGenerator Roof
Total Sq. Ft of Construction: 2900 SFt.of First Floor:
Cost of Construction:$ 6,960.00 Utilities:n Sewer[]Septic Building Height:
01NNER/LESSEEr F "' = CONTRACTOR ,, F
� a .
Name ROBERT&JUDY SEABORN Name: KYLE WHITE
Address:5205 MELVILLE ROAD Company: J.A.TAYLOR ROOFING, INC.
City: FORT PIERCE State:FIL Address: 302 MELTON DRIVE
Zip Code: 34982 Fax: City: FORT PIERCE State:FL
Phone No.772-359-7863 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: 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 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, consultwith I rider or an attorney before
com ncin work or recordingour Notice of Commenceme t.
ig re o caner/Agent/Lessee re of ontrac or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT LUCIE COUNTY OF SAINT LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 14TH day of SEPTEMBER 2011,151 by this 14TH day of SEPTEMBER ,20®by
KYLE WHITE KYLE WHITE
(Name of person now ed Ings) (Name of person ac now edgiIS Ait
)
c T-1
(Signature of No'tary Public-State of Florida) (Signature of Notary•Pu ic-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. FF115697 �,��a;o�ea (Sgh)REN S. NIELSE C mission No. FF115637 (Seal)
Commission#FF 1156 7
a: My Commission Expires KAREN S. NIELSEN
* Commission# FF 115637
,? My Commission Expires
Revised 07/15/2014 p
°;;,; "June 12, 2018
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