HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
fro LurcLL
�- l L5 C: ci 76 Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial x Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Roofing
PROPOSED IMPROVEMENT LOCATION:
Address: 9801 So. Ocean Drive, Jensen Beach, FL 34952
Property Tax I D #: 4502-501-0000-00010
Site Plan Name: Nettles Island, Inc., A Condominium
Project Name: Nettle Oceanside Pump Room
DETAILED DESCRIPTION OF WORK:
Roof per plans
\ 0%J
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
00
Lot No._
Block No.
Additional work to be performed under this permit — check all that apply:
Mechanical — Gas Tank —Gas Piping _ Shutters _ Windows/Doors Pond
Electric _ Plumbing _ Sprinklers _ Generator Roof 0112 Pitch
Total Sq. Ft of Construction: 300 Sq. Ft. of First Floor:
Cost of Construction: $ 6,833.00 Utilities: Sewer —Septic Building Height: 9'
OW N ERAESSEE:
CONTRACTOR:
Name Nettles Island, Inc., A Condominium
Name: Edward Campany
Address: 9801 So. Ocean Drive,
Company: Campany Roof Maintenance Roofing Division, LLC
City: Jensen Beach State: _
Zip Code: 34952 Fax: 772-229-9901
Phone No. 772-229-2930
Address: 917 28th Street
City: West Palm Beach State: FL
Zip Code: 33407 Fax:
Phone No 561-863-6550
E-Mail: manager@nettiesislandcondo.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Permitting@campanyroofing.com
State or County License CCC 1330613
11 MGIUC UI LU11Ol1ULLIU11 ib cauu ur mure, a KLt_UKutu NOT of commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: 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:
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 wil I, 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County 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.
r/ Lessee/Contractor as Agent for Owner
Signature of�01IDA
Signature of Contractor/License Hol er If
STATE OF F6
STATE OF FLOR DA
COUNTY OF Luc +=
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
5wofn to (or affirmed) and subscribed before me of
f Physical Presence or Online Notarization
14 P ical Presence or Online Notarization
this _"ay of t ' a , 2020 by
this Wday of 2020 by
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Name of pers n making statement.
Name of person makin statement.
Personally Known 'r/ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
T pe of Identification
Produced
P duced
(Signature of NoIva
torePNNotary Public- State�RfiFlr�rida ) JENNiFCi� M WOOp
Stm P of Florids
Commission No.��3
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ion GG 353888
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
QV. 5/6/20