HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -q-;s .— Permit Nu
RECEIVED
Building Permit Applicati n AUG 0 3 2098
Planning and Development Services ST. Lucie County, Permitting
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 -
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Address: 10701 S Ocean Dr #720 Jensen Beach FL
Legal Description: Venture Out Section C Lot 121 (OR 2695-2872)
PropertyTax ID#: 4511-805-0121-000-6 Lot No.
Site Plan Name: Block No.
Project Name: Mattson Roof
Setbacks Fronts Back: Right Side: Left Side:
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Remove existing shin gle roof and install new shingle roof
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Adchvonai WOrK to De Dertorme un ert~ispermtt—c ec a appy:
HVAC Gas Tank Gas Piping _Shutters Windows/Doors
Electric Plumbing
--]Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: 396 Sq.Ft..of First Floor:
Cost of Construction:$ 3300 Utilities:nSewer F Septic Building Height: 8'
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Name Bruce&Angela Mattson Name: Jamie Cisco
Address: 6558 Casabella Lane Company: Sunshine Roofing LLC
City: Boca Raton State: FL Address: PO Box 1083
Zip Code: 33433 Fax: City: Palm City State: FL
Phone No. 561-716-7902 Zip Code: 34991 Fax:
E-Mail: angeimml24@aol.com Phone No. 772-260-8195
Fill in fee simple Title Holder on next page(if different E-Mail: sunshineroofingllc@gmaii.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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or an9covenants 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,wails,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.
S g � a Ve Agent
-
SI nature of Owner Lessee/Co tractor as A ent for Owner Signature ontractor Li. nse
STATE OF FLORA STATE OF FLORIDA
COUNTY OF LuOe- COUNTY OF St Lucie
The f oin instru ent was cknowled�1,b efore me The fo in instru ent was a knowledge ore me
this day of if s 20CY by this ' day of (1 u6 20�y
Name of person making statement Name of person making statement
Personally Known OR Produced Identification `� Personally Known X OR Produced identification
Type of Identificgtion Type of Identification
Produced ftc�_-h5(z Produced
n
(Signatu a of Notary Public-Stake of Flor a) (Signature of Notb ate of Florida)
Commission No 4lll Notary gSoalbtate of Florida a Commission No. ep_YAL Notary Pu(ftfil)te of Florida
Marilyn l<luegei s Marilyn Kluegell
I c:rt� o� My Commission FF 230179 �N or MY Commission FF 280179
0. ��' Expires Or,/28/2019 `Fcf eso`' Expires 06!26!2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/27