HomeMy WebLinkAboutBuilding Permit Application!ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/28/19 Permit Number:Akl'N�'
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
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential X
Address: 1450 Copenhaver Road, Fort Pierce, FL 34945
Legal Description: 13 35 39 that part of N 1/2 of SW 1/4 of NE 1/4 LYG WLY of w r/w
Property Tax ID #: 2313-132-0001-000-0
Site Plan Name:
Project Name: Alan Johnson
Setbacks Front Back: _
DETAILED DESCRIPTION OF kWORK
E1HVAC
11 Electric ❑ Plumbing Sprinklers
j Total Sq. Ft of Construction: (5�5w
Cost of Construction: $ 10,250.00 Ut
Lot No.
Block No.
Right Side: Left Side:
ng E Shutters ❑ Windows/Doors
Generator W1 Roof I�12 Roof pitch
S Ft. of First Floor:
ilities:Sewer OSeptic Building Height:—��
OWN ER/LESSEE:
CONTRACTOR:
j Name Alan Johnson
Name: Jamie Cisco
Company: Sunshine Roofing, LLC
Address: 1450 Copenhaver Road
City: Fort Pierce State: FL
Address: PO Box 1083
City: Palm City State. FL
Zip Code: 34945 Fax:
Phone No. 772-260-0705
Zip Code: 34991 Fax:
Phone No. 772-260-8195
E-Mail: alan.johnson45@yahoo.com
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 IRFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
N am e: Alan Johnson
Address: 1450 Copenhaver Road, Fort Pierce, FL 34945
City: Fort Pierce State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: PO Box 1083
City:
Zip:
Phone:
MORTGAGE COMPANY: _ Not Applicable
Name: Jamie Cisco
Address: 1450 Copenhaver Road
City: Palm City State: _
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
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
lin 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,
laccessory 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 re VF
er/ Lessee/Contractor as Agent for Owner
STATE O �j
COUNTYJ �(� J
The forgoing instrument was acknowledged before me
this day of 064r)1� 20 9 by
�%I'lr� �� 51`l��i✓1
—� Name of person making statement t/
Personally Known OR Produced Identification
Type of Identification
Produced I i( D v is.P
Sign atur ' Contractor/License Holder
STATE OF FLORIQA
COUNTY OF U16t raj ✓�
The forgoing instrument was acknowledged before me
this '30 day of n C4,-) 43A-,r- , 2019 by
Name of personyMaking statement
Personally Known OR Produced Identification
Type of Identification
(S riatu d of N&y ublic- S t of o407ft,) STACY SANTA A fgnati
Notary Public - State
Commission No. Commission N G 041634
I'm... :`` My Comm. Expires 0.124. 2020
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
STACY SAN
Notary Public - SI
Commission #f
4y Comm. Expires
SUPERVISREVIEWOR I REV EW I VEGETATIEVI WON I SEA REVIEW LE I M EVIEWVE
Florida
1634
4, 2020