HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED )
Date: Permit Number:
r;s°
w.
RECEIVE®
Building Permit Application
Planning and Development Services LIAR 2 9 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
I .ROPOSED INI�PRC+VEMEIVT LOCATIN . ;:_.T w y.
Address: 7206 GEORGES RD, FORT PIERCE
Legal Description: LAKEWOOD PARK-UNIT 12-BLK 162 LOT 1
Property Tax ID#: 1301-614-0136-000-4 Lot No.1
Site Plan Name: Block No. 162
Project Name: BORGMAN/REROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
a4�
.ate. �
TEAR OFF SHINGLES. RE-NAIL DECK. INSTALL OWENS CORNING OAKRIDGE SHINGLE
ROOF SYSTEM OVER OWENS CORNING WEATHERLOCK G SELF ADHERED
UNDERLAYMENT. (36 SQ/3/12 PITCH).
CQNSTRUCTION INFORMATION '$ � � °"B
P4
itional work to be ertormed under this permit—check k a appy:
E1HVAC Gas Tank ❑Gas Piping a_Shutters Windows/Doors
11 Electric ❑Plumbing Sprinklers E Generator W1 Roof
Total Sq. Ft of Construction: 3600 SFt.of First Floor: 2190
Cost of Construction:$ 10,975.00 Utilities:In Sewer E]Septic Building Height: 1 STORY
01NN ER%LESSEE n CONTRACTOR
_ .r. < .P:
i.
w 4 A
Name CRAIG&ROSE BORGMAN Name: KYLE WHITE
Address:7206 GEORGES 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.772-631-5281 Zip Code: 34982 Fax: 772-468-8397
E-Mail:BORGMAN.CRAIG@GMAIL.COM 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:
m
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 b eco ded and posted on the jobsite
before the fiFs9hFPfction. If you intend to obtain financing, consul ith 1phcler or an attorney before
commenciy6Kwork o recording our Notice of Commencement.
s
_Signature of Own /Lessee/Agent Signature of Conti to License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The forgPing instr m nt wa acknowledge before me The for oing instrum t was acknowledged before me
this day of amn 20 Laby this day of 20 by
��111111111111y�j
KYLE WHITE KYLE WHITE
(Name of person acknowledging) ? :o°'�� 20 _ (Name of person acknowledging)
#FF 936050
( Ignature of Notary Public-State of F>� •'j.; NopNS;:Q��� (Si nature of Notary Pu lic-State of Florida)
/ / ypUBLIC S�a�����\\ 111111111111
Personally Known V OR Produced Ide({filiQp}itl111� Personally Known_�OR Produced I��i�� 1
Type of Identification Produced Type of Identification Produced P .••••••.. S �i�
Commission No. FF936050 (Seal) Commission No. FF 936050 ? � ��� ails?o°9N:. i
Revised 07/15/2014 'e�99`•`�; Bd1� X 0Ir ���
;NS**P.
111 11111111
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS