HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 02/24/17 Permit Number:lo�
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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
PROPOSED IMPROVEMENT LOCATION:
Address: 939 Nettles Blvd Jensen Beach, FL 34957
Legal Description: Nettles Island Inc,A Condo-Section II Parcel 939 And Pro-Rata Share In Common Elements(OR 2216-1094)
Property Tax ID#: 4502-501-1125-000-0 Lot No.
Site Plan Name: Block No.
Project Name: Ward Residence
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION, OF WORK:
Remove existing shingle roof and replace with 5-V.Metal
3/12
CONSTRUCTION INFORMATION:
Additional work to be nprtormed under t ispermit-check all appy:
HVAC Gas Tank ❑Gas PipingMGenerator
Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Roof
Total Sq. Ft of Construction: 1055 S . Ft.of First Floor: 1055
Cost of Construction:$ 6700 Utilities:nSewer ElSeptic Building Height: 8 Ft.
OWNER/LESSEE: CONTRACTOR:':
Name Donna&Ronald Ward Name: Jamie Cisco
Address:939 Nettles Blvd Company: Sunshine Roofing, LLC
City: Jensen Beach State:_ Address: PO Box 1083
Zip Code: 34956 Fax: City: Palm City - State:FL
Phone No.616-901-2093 Zip Code: 34991 Fax:
E-Mail: 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.
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Signature of Owner Agent/Lessee Signatur "of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF L} t oCI a COUNTY OF
The forcing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ( day of Mae,h 20�by this day of"re In 20_LTby
:Lnc j l),(`d Jamie Cisco
(Name of person acknowledging) (Name of person acknowledging)
(Signatu a of NotaJy Public-St to of Flor da) (Sign ture of Ndtary Pub/li State o Florida)
Personally Known OR Produced Identification ✓ Personally Known V OR Produced Identification
Type of Identification Produced Lii ce nae Type of Identification
ov pia Notary Public State of Florida
Commission No. &r �s� (ee�Fy Public state of Florida mmission No. Marilyn
My Camm F 230179
s. o Marilyn Kluegel TIP Expires 06/28/2019
My Commission FF 230179
Expires e 8120!9
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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