HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �' Permit Number:
Building Permit Application
Planning and Development Services MAR 21 '2018
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: RoofWIN
Address: 616 Nettles Blvd Jensen Beach, FL
Legal Description: Nettles Island Inc. A condo section II Parcel 616 and pro-rata share in common elements(OR 1291-2030)
Property Tax ID#: 4502-501-0802-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Remove existing shingle roof and replace with new shingle roof
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Additional work tobene as orme � asping under this permit-check a appy: M
❑HVAC LJ GTank GPi Shutters a Windows/Doors
— — —
Electric 0 Plumbing Sprinklers E]Generator Roof Cly Roof pitch
Total Sq.Ft of Construction: 811 S Ft.of First Floor:
Cost of Construction:$ 5400 Utilities Sewer Septic Building Height:
Name Marie Gambino Name: Jamie Cisco
Address: 616 Nettles Blvd Company: Sunshine Roofing LLC
City: Jensen Beach State: FL Address: PO Box 1083
Zip Code: 34957 Fax: City: Palm City State: FL
Phone No. 772-209-0887 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.
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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 Own6r-/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 6V Lu t:%e-- COUNTY OF St Lucie
The fo�/r� instrument was acknowled efore me The for ng instru ent wa acknowled a fore me
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this-l-�-�da y of �'�Gi�h 2q_6 by thisFday of 20 by
Name of person making statement Name of person making statement
Personally Known OR Produced Identification ✓ Personally Known x OR Produced Identification
Type of Identificatio Type of Identification
Produced !CLn Ste- Produced
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(SignaturV. .
I - (Signatu e
PJ" ry Public State of Flori a olrsl Ppp Notary Public State of Florid:
Commi i �� Seal Commission tf t Maril n Kluegel (Seal)
ommission FF 230179 �c ga My Commission FF 238179
es06/28!2019 '*oFF`o�' Expires06/28!2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17