HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/1t/19 - Permit Number:
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Building Permit Application �,�-, f
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Planning and Development Services '
Building and Code Regulation Division y, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof `��
PROPOSED IM'PROVEMENTLOCATION:
Address: C ' Ekz �✓LQ. 7
Legal Description. Millers S/D From Int of ELY R/WFEC RR and SLI of Lot 2,Run N61 Deg 30 Min E ALG S LI Lot 2,285.56 FT For POB,TH Cont N 6 Deg 30 Min
E 170 Ft,TH N 28 Deg 30 Min E 135 Ft to POB-Subject to an ESMT Over N 15 Ft-(6)(OR 867-517)
Property Tax ID#: 4504-603-0008-000-6 Lot No.
Site Plan Name: Block No.
Project Name: Friend Roof
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove tar& gravel roof and replace with new 5V metal panels C�D
Remove tar and gravel roof and replace with new modified rolled torch roofign
CONSTRIJCTlO'N INFORMAT,dON:
Additional work to be performed under thi_s_p_e_r_m—it_—__c_Feck all appy.
HVAC Gas TankIn
E]Gas Piping _Shutters a Windows/Doors
Electric 0 Plumbing' OSprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 13 Sqrs Pitch/10 Sqrs Flat Sq. Ft.of First Floor: 899
Cost of Construction:$ 13,400.00 Utilities:DSewer Septic Building Height: 8 Ft
OWN.ERAESSEE: CONTRACTOR: -
Name Cheryl Friend Name: Jamie Cisco
Address:12345 S Indian River Drive Company: Sunshine Roofing, LLC
City: Jensen Beach State:FL Address: PO Box 1083
Zip Code: 34957 Fax: City: Palm City State.FL
Phone No.772-497-4284 Zip Code: 34991 Fax:
E-Mail:jerezfriend@gmail.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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Cheryl Friend Name:Jamie Cisco
Address: Address: 12345 S Indian River Drive
City: Jensen Beach 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.
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 r f Owner/Lessee/Contractor as Agent for Owner Signatur of Contractor/License Holder
STATE F FLO STATE OF FLORIDA
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COUNTY OF �/-h✓t�. COUNTY OF )AII �
The f rgoing instrument was acknowledged before me The forgo instrumen was acknowledged before me
this�day of 20 S by this day of 20 'by
(IV) 0'nj I r2j Lv!J Q.
5iariiq if person making statement / Name of person making statement
Personally Kno n OR Produced Identification V Personally Known C/ OR Produced Identification
Type of Identify ation Type of Identification
Produced 1 Qif? _ Produced
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STACY G
Sig a re of ary at g, s rida) atur N blic-St It ]
Notary Public-State f loridaSTACY SANTAGATACommission GG 4 634
r Public•State of F , Comm.Expires Oc 2 ,2n2n
Commission No. • y fission No. � •
�a ommis:Ion#GG 041 34
kly Comm.Expires Oct 24 2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17