HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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 IIVP,ROVEMENT LOCATION:
Address: 124 QUEEN FREDERIKA COURT, FORT PIERCE
Legal Description: QUEENS COVE UNIT 1 BILK 4 LOT B
Property Tax ID#: 1414-701-0030-000-5 Lot No.
Site Plan Name: Block No.
Rroject Name: BETTIGA RE OFA
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
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TEAR-OFF SHINGLE. RE-NAIL DECK. INSTALL NEW SHINGLE ROOF SYSTEM OVER#30 FELT UNDERLAYMENT.
(35 SQ./6:12 P) REPLACE(2) EXISTING SKYLIGHTS WITH NEW SFA SKYLIGHTS.
CONSTRUCTION INFORMATION '` '`
Additional work to be ertormea unclertrus permit—check.all appy:
HVAC Gas Tank []Gas Piping _Shutters L..__L Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator W1 Roof
Total Sq. Ft of Construction: 3500 S Ft.of First Floor:
Cost of Construction:$ 9,600.00 Utilities: Sewer Septic Building Height:
C3WNER/LESS EEM, � CONTRACTOR,
Name WILLIAM&CAROL BETTIGA Name: KYLE WHITE
Address:124 QUEEN FREDERIKA COURT 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.772-342-1602 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.
SU?PLEMENTAL,.CONSTR.UCTION,.LIEIU LAW INFQRMATION
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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 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 in pection. If you intend to obtain financing, consult with lender or an attorney before
commencing woW or recording our Notice of Comm enceme t.
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S re w er Agent/Lessee *nure o n actor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINTLUCIE COUNTY OF SAINT LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 23 day of SEPTEMBERT 20L_J by this 23RD day of SEPTEMBER 200 by
KYLE WHITE I KYLE WHITE
(Name of person ackno le ng) (Name of per ackno le ging)
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(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 ype of Identification Produ
KAREN S. 115637 `����`pPrP�(i �j
Commission NO. FF115637 �,.�;pP�P�B(.�,�� C a)ssion# FFExpires OmmISSIOn NO. FF115637 _`O` a,n± C( 'p�1 N S. NIELSEN
'; _ * My Commission :N *` 7Y1//ssion�1 FF 115637
June 12, 2018 -.���,oF"o``��= My Commission Expires
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED