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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION: !,
Address: 3604 Sleepy Hollow lane
Legal Description: Savanna Club Plat Phase Three Blk 41 lot 22
Property Tax ID#: 3425-705-0023-000-5 Lot No.
Site Plan Name: Block No.
Project Name: Reroof
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: I j
Tear off and reroof shingles, using tamko 4in strip, and double 301b felt and GAF.shingles
3((,-y ,-I--ah ( S'i-ov-q J5SbaroS
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy:
HVAC E]Gas Tank E]Gas Piping Shutters ❑Windows/Doors
❑Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 2512 SFt.of First Floor:
Cost of Construction:$ 11250 Utilities:In Sewer[]Septic Building Height: loft
OWNERAESSEE: CONTRACTOR.,
NameDonaldAmig p {` Name: Jesus Jimenez
Address: 360H 1 � L 0MW Ln Company: JJ Quality Builders
W-
City: I 1 . t— cC J State:FL Address: 27541 SW 139 PI
Zip Code: 3qq52 Fax: City: Homestead State:FL
Phone No.610-349-7251 Zip Code: 33032 Fax:
E-Mail: Phone No. 561-855-6204
Fill in fee simple Title Holder on next page(if different E-Mail: info@jjqualitybuilderspb.com
from the Owner listed above) State or County License: CCC1329998
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 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 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
commencmg work or r rding your Notice of Commencement.
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SignatulVof Owner/Lesse contractor as gent for Owner Signature Contractor/Lice Holder
STATE OF FLORIDA (J STATE OF FLORIDA
COUNTY OF P4L_M hGAC 4 COUNTY OF p4-LN BF-40-4
The for oing instru ent was acknowledged before me The forgoing instrument was acknowledged before me
this a day of `�u�v 20 -[I-by this fL day of Jury 20 17 by
i JESUS J IMC—NEZ JESUS ��1Mc—n1EZ.
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-S to of Florida (Sig ture of Notary Public-State of orida)
o,�ParP°°� N �A I� DUQUE
Personal) Known ,........bR j'ro ce dentlficatlon Person I '/__.. .
Personally =; dL �I yrawn OR Pro;fu.Q�reff6fi ation
MY COMMISSION#FFO a
Type of Identificatio �r erl Type of1"(407)
irntlfilcation Produced:"&
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nv
EXPIRES January ,�'` „•.,.,,
Commission No. (407)39.8 1,0153 Florid gp� Service.com CommiE§AJQ Uff4 UE
ion N. ;=_
3 ®? N10599
EXPIRES January 13,2018
Revised 07/15/2014 (407)398-0153 FloridallotaryService.com
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