HomeMy WebLinkAboutBuilding Permit Application 1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED p
Date: Permit Number: l��r�)_-- o 3n
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:.
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!Address: 2120 Nettles Blvd Jensen Beach, FL `
'Legal Description: Nettles Island Inc. A Condo Section 1 Parcel 120 and Pro-rata share in common elements (OR 3674-790)
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Property Tax ID#: 4502-501-0123-000-9 Lot No.
Site Plan Name: Block No.
Project Name: DeFalco
Setbacks Front Back: Right Side: Left Sider
DETAILED DESCRIPTION OF WORK:
Remove existing shingle roof and install new shingle roof
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy:
E1HVAC E]Gas Tank Gas Piping _Shutters E]Windows/Doors
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Electric ❑Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:;1308
Cost of Construction:$ 7000 Utilities:Sewer 11 Septic Building Height: 8'
OWNER/LESSEE,: CONTRACTOR:;
Name Laura DeFalco Name: Jamie Cisco;
Address:2120 Nettles Blvd Company: Sunshine Roofing, LLC
City: Jensen Beach State:_ Address: PO Box 1083
Zip Code: 34957 Fax: City: Palm City ! State:FL
Phone No.772-924-5722 Zip Code: 34991 Fax:
E-Mail:Idlifestyles@gmail.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.
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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: l;
Address: Address:
:City: City:
Zip: Phone: Zip: Phone:
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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
:commWTing work or recording our Notice of Commencement.
i nature of Owner/Agent/Lessee Signature of Contract i /License'Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF we.)e COUNTY OF a� Lucr e,
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The forgoing instrument was acknowledged before me Theyq��oing instrument was acknowledged before me
this f�day of�eeem bei' 20 17 by this o!r" day of I r 20_4 by
L,6 Jamie Cisco
La ura.
'(Name of person acknowledging) (Name of person acknowledging)
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(Signat re of NotAry Public-Istate of F rida) Sign ure of N tary Publi State f orida)
Personally Known I a tification X Personally Known X I OR Produced Identification
Type of Identification Produ d ijgqgpe ype of Identificatir.,P
dtlse+e
IC to of Florida y Pua Marlly KlUegel o Notary�e*
Commission No gg A6ea missionFF23o179 ommission No. FMarily
oaf►°Q Expires 06!28/2019 ��o y Commission FF 230179
�OFf�° Expires 06/28/2019
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Revised 07/15/2014
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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