HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 ��6 Permit Number: ��03�4555
RECEP.'rD LIAR 2 9 2016
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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
PROP„OSED°1NIPROVEME
NTLOCATIQN:
Address: 642 PONYTAIL LANE, FORT PIERCE
Legal Description: PALM GROVE S/D BILK L LOT 30
Property Tax ID#: 3410-503-0368-000-9 Lot No. 30
Site Plan Name: Block No. L
Project Name: BEARSE/REROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
TEAR OFF SHINGLES. RE-NAIL DECK. INSTALL OWENS CORNING OAKRIDGE SHINGLE
ROOF SYSTEM OVER 30# FELT UNDERLAYMENT. (36SQ/5/12 PITCH).
CONSTRU❑'ION” IN'FORM"ATION
Additional work toe nertormed under this permit—check a appy:
HVAC Gas Tank Das Piping _Shutters L1Windows/Doors
11 Electric ElPlumbingSprinklers E Generator W1 Roof
Total Sq. Ft of Construction: 3600 SFt. of First Floor: 2440
Cost of Construction:$ 8,900.00 Utilities:Sewer Septic Building Height: 1 STORY
O*NER/LESSEE: :r �CONTRACTOR:
Name TIMOTHY&MARY BEARSE Name: KYLE WHITE
Address: 642 PONYTAIL LN Company: J.A.TAYLOR ROOFING INC
City: FORT PIERCE State:FL Address: 302 MELTON DR
Zip Code: 34982 Fax: City: FORT PIERCE State:FL
Phone No.401-225-4338 Zip Code: 34982 Fax: 772-468-8397
E-Mail:BEARSEB@COX.NET 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.
zN
.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 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 our property.A Notice of Commencement must be rec and posted on the jobsite
before the fir inspe ion. If you intend to obtain financing, consult wi a er or an attorney before
commencin w o r cording our Notice of Commencement.
— -� vl�- . -- - 4__)�P s
_Signature of Owner/Lessee/Agent Signature o ontractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The for oing instru a was acknowledge efore me The for�}omg ins trume t was a knowledged before me
this 9day of 1^CK 20 Mby this TA day of r 20 t(,p by
KYLE WHITE KYLE WHITE
(Name of person acknowledging) (Name of person acknowledging)
al
(Si nature of Notary Public-State of Florida) (SigAatLrre of Notary Public-State of Florida)
Personally Known OR Pr ion Personally Known OR Produced Ic"ptlflHbb1
Type of Identification Produced���� .••••••. S ���i Type of Identification Producedrl
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Commission No. FF936050 0J¢�brSeS �9N;. Z Commission No. FF936050 •. Q�� 8f15?A9• y
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