HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED a�^-
Date: o�� Permit Number: 'W V�—��DO
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RECEIVED
Building Permit Application
Planning and Development Services FEB 1' 7 2016
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 I MPROVEME N1 LOCATION: << ,
Address: 7501 SALERNO RD, FORT PIERCE
Legal Description: LAKEWOOD PARK-UNIT 6-BLK 68 LOT 20 AND E 1/2 OF LOT 21
Property Tax ID#: 1301-606-0250-000-4 Lot No.20
Site Plan Name: Block No. 68
Project Name: LEAL/REROOF
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION OF WORK
TEAR OFF SHINGLES. RE-NAIL DECK. INSTALL OWENS CORNING SHINGLE ROOF SYSTEM
OVER (30#) UNDERLAYMENT. (35 SQ/4/12 PITCH).
CQNSTRUCTION INFORMATION.
Additiona I work to be nertormed u ncler t is permit—c ec k a 11 appy:
HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric E]PlumbingSprinklers I Generator W1 Roof
Total Sq. Ft of Construction: 3500 S Ft.of First Floor: 3478
Cost of Construction:$ 9275.00 Utilities. —Sewer Septic Building Height: 1 FL
OWNER/LESSEE: CONTRi4CTOR. '
Name DIANE LEAL Name: KYLE WHITE
Address: 7501 SALERNO RD Company: J.A.TAYLOR ROOFING INC
City: FORT PIERCE State:FL Address: 302 MELTON DR
Zip Code: 34951 Fax: City: FORT PIERCE State:FL
Phone No. 772-2428477 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.
SU.,PPIEMENTAL.00NSTRIJCTION LIEN L�4W INFRMATI�N .'
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 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 w' h the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following ilding per it applications are exempt from undergoing a full conc r ency review:room ditions,
accessory str tures,swi ing pools,fences,walls,signs,screen rooms and acc s ory uses to another on-residential use
WARNIN O OWNE Your failure to Record a Notice of Commence nt may result in y r paying twice for
improve nts to you roperty. A Notice of Commencement mus a recorded and p sted on the jobsite
before th rst inspe ti n. If you intend to obtain financing, cons t with le der or an ttorney before
CID en rk o r ording Vour Notice of Commencement.
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_Signature o O er/Lessee/Agent Signature df Co racto I
icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST.LUCIE COUNTY OF ST.LUCIE
The for ping instruwqnt was acknowledged before me The forgoing instr ent was acknowledged before me
this day of 1-6106-VC, 20 Me by this l5 day of 20 0 by
���`���0\NE MRF�i,, \����`` MRF vii,
KYLE WHITE -,0IC�_•!:V Q nA'•:s� �i KYLE WHITEC�Q.•.41�S��N,.''s9
(Name of person acknowledging) ;p ber is �0 (Name of person acknowledging) vo 't'er
•cS= SDN• � �aSZ SDN:*_'.
#FF 936050 • ;Q #FF 936050 ;Q
(Si ature of Notary Public-State of ed1�N 'Q� (S' nature of Notary Public-State of
o ,
'ijp•: E;NopN�;O
Personally Known �OR Produced I���h)! T����`� Personally Known V OR Produced
Type of Identification Produced Type of Identification Produced
Commission No. FF 936050 (Seal) Commission No. FF936050 (Seal)
Revised 07/15/2014
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DATE
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INITIALS