HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Chi
Date: Z: �01 Permit Number:
- RECEIVED
Building Permit Application
Planning and Development Services DEC 2 3 2019
Building and Code Regulation Division
p®rmf�in9 De artment
2300 Virginia Avenue,Fort Pierce FL 34982 uEl@edfl�
Phone: (772)462-1553 Fax: (772)462-1578 Commercial ResiclentTgtal�x
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 1190 NETTLES BLVD JENSEN BEACH FL 34957
Legal Description:
NETTLES ISLAND INC,A CONDO-SECTION II PARCEL 1190 AND PRO-RATA SHARE IN COMMON ELEMENTS(OR 4123-161
Property Tax ID#: 4502-501-1377-000-1 Lot No.
Site Plan Name: 1190 NETTLES BLVD Block No.
Project Name: SHINGLE TO SHINGLE
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REMOVE EXISTING SHINGLES DOWN TO THE WOOD DECK AND INSTALL NEW
DO �COOA 600
EC:O:NSTRUCTION INFORMATION:
Additional work to be Dertormed under t Ispermit—check all appy:
E]HVAC Gas Tank F_]Gas Piping _Shutters Windows/Doors
11 Electric 0 Plumbing O Sprinklers E Generator Roof 4:12 Roof pitch
Total Sq. Ft of Construction: l6t)1) S . Ft.of First Floor:
Cost of Construction:$ hd "— (06 Ill ies: _Sewer[]Septic Building Height: IS
OWNER/LESSEE: CONTRACTOR
Name James R Krug - Name: Javier Solis
Address: 164 C7r4ystone LN Company: SOLIS ROOFING CONTRACTORS INC.
Stoystown, State: PA Address: 1033 SW Dalton Ave
Zip Code: 15563 Fax: City: Port St. Lucie State:FL
Phone No. Z" Zip Code: 34953 Fax: 772-878-4097
E-Mail: 11#IKV / Q / Phone No. 561-662-6622
Fill in fee simple fitle Holder on next page(if different E-Mail: SOLISROOFINGINC@GMAIL.COM
from the Owner listed above) State or County License: CCC1330147
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
ii
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SUPPLEMENTAL CONSTRUCTION}LIEN LAW INFORMATION:
DESIGNER/ENGINEER: i X Not Applicable MORTGAGE COMPANY: x 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: Name:
Address: Address: J
City: City: II
Zip: Phone: Zip: Phone: II
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 of Owner/Lessee/Con ctor as Agent for Owner Signatu-e of Contractor/License Holder
I
STATE OF FLORIDA // / STATE OF FLO A - _r I
COUNTY OF Scel n " ,f tJG/,� COUNTY OF —3a 1- C Le
The forgoing instr ent was cknowledg efore me The for oing instr�entwagcknowledged before me
this�day of ' 20 by this�day of lae 20& by
Name of persorymaking stat nt Name of perso making statement
Personally Known ��// OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
—W,4" A,,-,
(Signature of Nota Ja� (Signature of Nota P blic-State of Uariria
MAPA
Commission No. ' � MY(�MIQ�i GG251 Commission No. `''� AM
N �f4,2� = pd 2023
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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
I .