HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �}
Date: 8/21/19 Permit Number: �Ioo_ bl ��
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Building Permit Application err„trn
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Planning and Development Services '� �nH e77t
Building and Code RegulationiDivision
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATIONFOR: Roof
'PROPOSED IMPROVEMENT LOCATION:
Address: 917 Jackson Way, Hutchinson Island
Legal Description: COASTAL COVES-UNIT 1-LOT 24 (OR 3694-964)
Property Tax ID#: 1423-802=0026-000-2 Lot No.24
Site Plan Name: Block No.
Project Name: Fasnacht
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION'OF WORK:
Remove existing 5V crimp metal roof and replace with new 5V Aluminum metal roof
CONSTRUCTION INFORMATION:
Additionalwork toe e orme un er this permit—check a appy:
HVAC E]Gas Tank []Gas Piping _Shutters ❑Windows/Doors
Electric 0 Plumbing OSprinklers ElGenerator W1 Roof 3 12 Roof pitch
Total Sq. Ft of Construction: 2,712 S . Ft. of First Floor:
Cost of Construction:$ 31,600.00 Utilities:
Septic Building Height: 8 Ft
-bWN ER/LESSEE: CONTRACTOR:.
Name Debra Fasnacht Name: Jamie Cisco
Address:917 Jackson Way Company: Sunshine Roofing, LLC
City: Hutchinson Island State:FL Address: PO Box 1083
Zip Code: 34949 Fax: City: Palm City State:FL
Phone No.772-882-5748 Zip Code: 34991 Fax:
E-Mail:nicole@hardscapesinc.net 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.
SUP,PLEMENTAL.CONSTRU,CTION LIEN LAW INFORMATION-
DESIGN ER/ENGINEER:
N.FORMATION:DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:I 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:
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 ford
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
commgRing work or recording our Notice of Commencement.
J1 111171,d - 7
X—igna-ture o Owner/Less a/Contractor as Agentfor Owner Signature of Contractor/License Holder
STATE OF FLQRkD�A STATE OF FLORIDA
COUNTY OF COUNTY OF� `�,�1�1
The ng instrument was acknowledg d efore me Th ging instrument was acknowled efore me
this day of 20y this day of�(1 �1'�n 20 y
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Name of person making statement Name of perso aking statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of,t ' "cation Type of Identification
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(Si ature (Signature of Notary Public-2
of Florida)
Commissio Cid. MY COMMISSION#g@11 R� Commissi �! TIE DYE;93UM
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P 1VEXPIRES: ber 11, ,,. ;t: MY COMMISSION 1e GGBonded Ttw NctarY Pubec Unaervnitere =3. EXPIRES:December 1REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEAT RJANGROVE
COUNTER' REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17