HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE,INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
x
- - 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
PERMITTYPE: Reroof
PROPOS'ED'INPROVEMENT'°LOCATION::; '
Address: 10725 S Ocean Dr #423 Jensen Beach FL
Property Tax ID#: 4511-502-0141-000-2 Lot No.
Site Plan-Name: Block No.
.Project Name:
DETAILED DESCIRIPTIOM01=WORK-1
Remove existing shingle roof and install new shingle roof
CONSTRUCTIO,N�INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
,, ,,,
Electric _Plumbing _Sprinklers _Generator _Roof �Pitch
Total Sq. Ft of Construction: 744 Sq. Ft.of First Floor:
Cost of Construction:$ 3850 Utilities: —Sewer _Septic Building Height:
OWN ER/LESSEE: V :CONTRACTOR:
Name Kenneth&Kathleen Pirtle Name:Jamie Cisco
.Address:6125 Dublin Rd Company:Sunshine Roofing LLC
City: Delaware State:_ Address:PO Box 1083
Zip Code: 43015 Fax: City: Palm City State:FL
Phone No.614-203-1311 Zip Code: 34991 Fax:
,E-Mail:ken@sonassociates.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.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION IIEN.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:
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.
Signat f Owner/Lessee/Contractor as Agent for Owner Signature Contractor/License Holder
STATE OF FLORIDA STATE OF FLOgr1_JA'Ie_COUNTY OF l •f. L UQ- I e- COUNTY OF
The f ff�o,�.n,g instrument was acknowledg before me The forgoing instr4mept was acknowledg before me
this&��ay of 20 by this day of I—e- r'Uary 2011 by
I r 1,2 Jamie Cisco
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification t/ Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced tken'-R Produced
(Signatu a of Notar (Signature of Notak Publ' - t I
N tary Public St to of Florida l
Commission No. a Marilyn Klupp��gggg 11 °ee Notary ublic State of Florida f
v Commis�id� 0230.979 Commission No. _° Madly65eWlel #
�OF c►° Expires 06/28/2019 y� My Commission FF 230979 '(
'FOF F Expires 06/28/2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.9/26/18
IL
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