HomeMy WebLinkAboutBuilding Permit Application a
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: "�I 1���� Permit Number:
RECEIVED
Building Permit Application SEP 18 9019
Planning and Development Services ST. Lucie Count
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 IMPROVEMENT LOCATION:
x.
Address: 109 Rio Mar Court Pt St Lucie, FL 34952
Legal Description: River Park-Unit 10-Blk 83 Lot 3 (MAP 34/22S)(OR 3627-2002, 2004)
Property Tax ID#: 3419-575-0004-000-0 Lot No.3
Site Plan Name: Block No. 83
Project Name: Tiemeyer Residence
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove tar& gravel roof and replace with new modified rolled roofing
CONSTRUCTION INFORMATION
Additionalworkto e performed under this permit—check a appy:
HVAC D Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric ElPlumbing Sprinklers 0 Generator Roof 112 Roof pitch
Total Sq. Ft of Construction: 28 Squares S Ft.of First Floor: 1316
Cost of Construction:$ 10,000 Utilities. Sewer E]Septic Building Height: 8 Ft
OWN ER/LESSEE: 'CONTRACTOR
Name Andrew Tiemeyer Name: Jamie Cisco
Address:296 Cabana Point Circle Company: Sunshine Roofing, LLC
City: Stuart State:FL Address: PO Box 1083
Zip Code: 34994 Fax: City: Palm City State.FL
Phone No.772-408-3158 Zip Code: 34991 Fax:
E-Mail:andyt929@yahoo.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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:AndrewTiemeyer Name:Jamie Cisco
Add ress:109 Rio Mar Court Pt St Lucie,FL 34952 Address: 296 Cabana Point Cirde
City: Stuart 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.
Signature o Owner/Less ee/Contrac as Agent for Owner Signatur of Contractor/License Holder
STATE OF FLORIDA,� STATE OF FLORIDA
COUNTY OF "y�nc8i— COUNTY OF A&h"J
The forgoing instrument as acknowledged before me The f rgoing instrument was acknowledged before me
this day of , 20]q by this�day of 20 ^ by
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Name of pers making statemen Name of person gawking statement
Personally Known OR Produced IcTentification Personally Known V OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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Si ture o N ic-S` e q t o of Not P�ibJicr
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17