HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �' �� lam Permit Number: J a-0,� ap-
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Building Permit Application RECEIVE®
Planning and Development Services
Building and Code Regulation Division OCT 14 2015
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PROPOS,E04NPRC�VEMEN- LOCATI N gaga>a � k ��kb ,x
Address: 1684 CHRISTMAS COVE DRIVE, FORT PIERCE (MOBILE HOME)
Legal Description: GOLDEN PONDS MOBILE HOME PARK: 3 35 39 NW 1/4-LESS AVON MANOR-UNITS 1 &2&LESS W
615.5' LYG S OF AVON MANOR-UNIT 1 AND LESS CANAL&RD RSM&LESS 1-95 AS IN OR 237-1372
Property Tax ID#: 2303-211-0025-000-5 Lot No.
Site Plan Name: Block No.
Project Name�DUF3:QCHER-REROOF-(MOBIL--E-HOME)-�----�
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.
INCLUDES REMOVING (2) EXISTING SKYLIGHTS. REPLACE WITH NEW SKYLIGHTS.
(17SO./3:12P)
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Cb:NSTRUCTION I,NEORMATION '" '
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Additional work toa nertormed under this permit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
❑Electric ElPlumbingSprinklers ❑Generator W] Roof
Total Sq. Ft of Construction: 1700 SFt.of First Floor:
Cost of Construction:$ 5,800.00 Utilities:n Sewer Septic Building Height:
OWNER%LESSEE N-. :CONTRACTQR G {
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Name LAWRENCE DUROCHER Name: KYLE WHITE
Address: 1684 CHRISTMAS COVE DRIVE Company: J.A.TAYLOR ROOFING, INC.
City: FORT PIERCE State:FIL Address: 302 MELTON DRIVE
Zip Code: 34945 ' Fax: City: FORT PIERCE State:FL
Phone No.772-466-8055 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 LIEaN,LAW INFORMATION:, au .
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 thepermit 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 inspe&tion. If you intend to obtain financing, consult with lender or an attorney before
commencing wo¢k oOrecording your Notice of Commencement.
,
Signature of Owner/Agent/Lessee Signature of Contra c k/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINTLUCIE COUNTY OF SAINT LUCIE
The forgoing instrument was acknowled gd before me The forgoing instrument was acknowledged before me
this 13TH day Of OCTOBER 20LM by this 13TH day of OCTOBER 20 Mby
KYLE WHITE KYLE WHITE
(Name of person ac n wledgin ) (Name of person owledgin ,)
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(Signature of Not; u lic-State of Florida) (Signature of Notary Pu lic-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. FF11e637 Seal Commission No. 11115837 (Seal)
”" KAREN S. NIELSEN
,,.pT c'�B,ice {<AREN S. Nrr
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IELSEN
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- ommission
My Commission Expires +_
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Revised 07/15/201 '!jrF,FGIVFI June 12, 201 8
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