HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:Nor
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 LOCATION:
Address: 660 Nettles Blvd,Jensen Beach, FI
Legal Description: Nettles Island Inc.,A condo-section 11 Parcel 660 And Pro-rata share in common elements(OR 1219-1998;3259-352)
Property Tax ID#: 4502-501-0846-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
r
Remove eisting shingle roof and replace with new metal roof
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
1-1 Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 864 S Ft.of First Floor: 864
Cost of Construction:$ 6500 Utilities: _Sewer Septic Building Height: 8
OWNER/LESSEE: CONTRACTOR:'; j
Name Clarence Steenwyk Trust Name: Jamie Cisco
Address:2655 92nd St SW Company: Sunshine Roofing, LLC
City: Byron Center State:MI Address: PO Box 1083
Zip Code: 49315 Fax: City: Palm City State:MI
Phone No.616-437-1828 Zip Code: 34991 Fax:
E-Mail:rsteenwyk2@aol.com Phone No. 772-260-8195
Fill in fee simple Title Holder on next page(if different E-Mail: sunshineroofingllc@gmail.com
from the Owner listed above) State or County License: CCC1327796
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: 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 or recording our Notice of Commencement.
Signature of Owner/Agent/Iressee Signature-o Contractor License o er
STATE OF FLORIDASTATE OF FLORRI-D-A
COUNTY OF f n&v1`AA" COUNTY OF 9)ar4)
The forg ing instrument was acknowledged before me The forggi a instru r>,t was acknowledged before me
this_�ay of ��^uari 20�by this L ay of ,20by
rQlr� �' Mn W k. 1 rLe ee- Jamie Cisco
(Name of person acknowledging) (Name of person acknowledging)
�In" -� &a�&L I —r--)6,—QA, , idz��
(Signatu a of Notarl Public-St to of Flo ida) (Signat re of Notaly Public-Sta)a of Florida)
Personally Known OR Produced Identification X Personally Known X OR Produced Identification
Type of Identification Produced License Type of Identification Produced
Commissio' o rn
zo;DQ
Otary-Pubilc State ofbCommission No. c ° �Pitoof
lorlda Marilyn Klue
Marilyn Kluegel ri
OF Flc Expires o6/28/2019 of�� Expires 06/28/2019
Revised
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS