HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE`INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I15\�6 Permit Number: 1r 0 , –d\,�Vs
• REC�JVEQ JAN 15 2016
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 IMPROVEMENT LOCATIC)N:
Address: 262 BERMUDA BEACH Dikd
Legal Description: CORAL COVE BEACH-SECTION ONE-BLK 4 LOT 17
Property Tax ID#: 1425-701-0081-000-1 Lot No.17
Site Plan Name: Block No. 4
Project Name: HENRY/REROOF
Setbacks Front Back: Right Side: Left Side:
DERAILED DESCRIPTION DF1NORK w ' m
TEAR OFF FLAT ROOF. RE-NAIL DECK. INSTALL POLYGLASS FLAT ROOF SYSTEM, OVER
PEEL AND STICK BASE TORCH CAP UNDERLAYMENT (16 SQ/ FLAT).
Mod Q�
CONSTRUCTIQN;INFORMATION 1'.1
itiona work to be nertormed under this permit–check all appy:
HVAC Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑Plumbing Sprinklers Generator W1 Roof
Total Sq. Ft of Construction: 1600 S Ft.of First Floor: 3781
Cost of Construction:$ 6,400.00 Utilities. —Sewer[]Septic Building Height: 1 FLOOR
OtN.'NER/LESSEE: TCONTRACTOR:
Name CHRISTOPHER HENRY Name: KYLE WHITE
Address: 262 BERMUDA BEACH DR Company- J.A.TAYLOR ROOFING INC
City: FORT PIERCE State:FL Address: 302 MELTON DR
Zip Code: 34949 Fax: City: FORT PIERCE State:FL
Phone No. 772-260-3612 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: NADINE@JATAYLORROOFING.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:
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
commencing work pr recording our Notice of Commencement.
.P. J Vk Ll' s
_Signature d0 ner/Lessee/Agent Signature of Con ctor/License Holder
STATE OF FLORIDA ` STATE OF FLORIDA
COUNTYOF
���V Circe
COUNTY OF �� LU C1
The for oing Instrurnent was acknowledg d before me The forgoing instrument was acknowledged before me
this day ofQY�l9( 20-by this_&day of 20 by
KYLE WHITE KYLE WHITE
(Name of person acknowledging) (Name of person acknowledging)
(Si nature of NotaryPubli -State of F,I�o\`` ►1�1NE M �i (Si ature of Notary Public-State of Florida�NE
Personally Known k"""OR Prod t p�ed�lcl� r �ip�? % Personally Known t R Produgleli
Type of Identification Produced v ember 1S`�o: s Type of Identification Produced ;��M� 0,V
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9
Commission No, bs: (5 �4W'� :*z Commission No. 5e,&U
o: 936050
o
#FF 936050 ;Q.
Revised 07/15/2014 � �I if A11 O\�\O\\\\ /',��94jGBClt •p�( �0�`\
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
=INITIALS