HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/21/19 Permit Number:
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 Commercial X Residential
I PERMIT APPLICATION FOR: Roof I
Legal Description:
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Property Tax ID #:2&2� - 131 - 06C)cr)-- C-00 -0 Lot No. U
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Additional work tobe Dertormed under this permit —check all apply: —1
0_HVAC E]Gas Tank F]Gas Piping Shutters Windows/Doors
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Electric F]Plumbing OSprinklers OGenerator L
,�J Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: 0SewerF ]Septic Building Height:
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/Address:,
50
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City:. State: FL
Zip Code: Fax:
Phone No.-),nr
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from the Owner listed above)
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Name: Jamie Cisco
Company: Sunshine Roofing, LLC
Address: PO Box 1083
City: Palm City State: FL
Zip Code: 34991 Fax:
Phone No. 772-260-8195
E -Mail: sunshineroofingllc@gmaii.com
State or County License: CCC1 327796
AWIN
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
_
Name: Jamie Cisco
Address:
Address:
City: 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 thepermit 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
commencfflg workorrecording your Notice of Commencement.
Sig aturp—o Owner/ Le see/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLO IDSTATE
COUNTY OF (_)COUNTY
OF FL IDA
OF _ A,.(—,
The ing instrument w s acknowled before me
thin, day of 2{k ` )by
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The oing instr ent wa acknowled d before me
this day of .� � ( _ 24° y
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Na f person making statementName
Personally Known OR Produced Identification
of person njaking statement
Personally Known OR Produced Identification
Type of, cation
Type of Identification
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Produced
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REVIEWS
FRONT ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17