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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:-8LZ41'9'.AL. ,11� Permit Number:
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Building Permit ApplicatiPlanning and Development Services
Building and Code Regulation Division mitting
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:
Address: 176 Liberty Way
Legal Description: Bel-Aire Estates BLK 1 Lot 4(OR1089-1771)
Property Tax ID#: 1312-701-0005-000-8 Lot No.4
Site Plan Name: Block No. 1
Project Name: Creel Reroof
Setbacks Front Back: Right Side: Left Side:
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DETAILED DES�DESCRIPTION OF WORK:
Remove shingle roof and replace with 5V metal.
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CONSIT..RUCTION. I N FORMI TION:
Additional work toe e orme under this permit—check a appy:
HVAC Ei Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11Electric 0 Plumbing OSprinklers Generator Roof 3 12 Roof pitch
Total Sq. Ft of Construction: 1984 S Ft.of First Floor: 1984
Cost of Construction:$ 10500 Utilities: LJ Sewer E]Septic Building Height: 8 Ft
OWNER/LESSEE: CONTRACTOR:
Name Larry Creel Name: Jamie Cisco
Address:176 Liberty Way Company: Sunshine Roofing, LLC
City: Ft Pierce State:FL_ Address: PO Box 1083
Zip Coder 34951 . Fax: City: Palm City State:FL
Phone No.772-465-0190 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Larry Creel Name:Jamie Cisco
Address:176 Liberty way Address: 176 Liberty Way
City: Ft Pierce State: City: Palm City State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:PO Box 1083 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.
sign atu re(�plwner/L see/Contractor as Agent for Owner Signature Contracto`License Holder
STATE OF FLORID � STATE OF FLORIDA
COUNTY OF a1 a >I 7A - COUNTY OF n�The forgping instrum,Ant was acnowledge before me The forgo'ng instrum nt was acknowledged before me
this day of ° •�- 20 by this day of 20� by
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Name person making statement / ame of person aking statement
Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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i n ture o N a P ic-Sta a of Florida) (S' ure of N ub' St
P�4� STACY SANTAGA
Commission No. J 1g,s ?o.�r"' c I) STACY SANTA AT*mmis on No. 0 :�r; .°VSQ&ry Public:State of Ell fida
_ a Notary Public=Stat .of Florida Commission N GG 04 614
Commission#t G 041634 My My Comm.Expires Oct 2 J 020
REVIEWS FRONT rt 13V Ir VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17