HomeMy WebLinkAboutBuilding Permit Application i
All APPLICABLE INFO MUST BE
COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:��� "\ Permit Number:
J.
Building Permit Applicatildby .9 20'g
Planning and Development Services pC3rmlt
Building and Code.Regulation Division 5t, L u9��oa.Rrnent
2300 Virginia Avenue,Fort Pierce FL 34982 tY
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential x
PERMIT TYPE:Re-roof with 1" .032 painted aluminum standing seam
PROPOSED IMPROVEMENT;LOCATI�N
Address: 1055 Nettles Blvd, Jensen Beach, FL
Property Tax ID#.. 4502-501-1242-000-6 Lot No.
Site Plan Name:'Nettles Island inc section II parcel 1055 and pto-rata'share in common Block No.
Project Name: Martin Re-roof
DETAILED"DESCRIPTION O;F=WORK: ,i
Tear off existing tile roof system. Install self=adhering modified underlayment, back nailed.to code. Install
.032 painted standing seam metal roof system to code with'1" panhead screws.
_CONSTRUCTION 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 __V/Roof Piteh
Total Sq.Ft of Construction: 1300 Sq. Ft.of First Floor: 1093
Cost of Construction:-$ 13,000:00 Utilities: —Sewer —Septic Building Height: 20'
O.SNNER/LESSEECONTRACTOR .
_— --
Nam-- ..,...t,-Shawn D Martin, Name: MAIWMI `1C(YA SazVCStct�
Address:1596 Woodway Rd, Company:Si�— ��a !iyy\e�.r6 ,
City: Kent, OH State:_ Address:" �Li S l✓0`lb (_Zy IN
Zip Code: 44240 Fax:(330)673-7467 'City: '? vv Sir' V J C« Stater
Phone No.(380).283-3232 Zip Code: 31f.c;LN'1,, Fax:
E-Mail:smartin@rwmartin.com . Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License-CCX133 OtIn 6
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.
7777777,
:SUPP,LEIVIENTAL 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: Naive:
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 theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or angcovenants 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 accessary 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 Tt1E JJDB SIT EFORE THE.FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR L+N ATTORNEY BEFORE-RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/Lessee/Con. s Agent for Owner Signature of Contractor/License Holder i
STATE OF FLORID STATE OF FLORIDA
COUNTY.OF � �1'� COUNTY
The forgoing instrument Was acknowledged before me The for ing instrument was acknowledged before me
this I day of �i s y1�, 20�Q. by this�ay of 20 .13y
n OVIV4LA _2r\)A9=L
Name of person making state ent; Name of person making/statement.
Personally Known OR Produced identification T1 Personally Knowny OR Produced Identification
Type of Identification Type of Identification
Produced SeyiSe,__ Produced
bskqw
(Sign �� H (Signa HERYL A HCITTEN MI7H
si Y z MY COMMISSION#GGf���O 'Y
Comm�"!a ci*: Comm 'moo ;'=MY COMMISSION#GGO4�
�' EXPIRES April 04,2021 r,�"�� EXPIRES Apri#04.202i
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW .REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19