HomeMy WebLinkAboutSanon ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. Permit Number:
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
7,r -44 r* r4- T, M
I PERMIT APPLICATION FOR: Roof I
Address: Ln, V-0F_-t-
Legal Description: Sheru_)M-d nCne-S a4
Property Tax lD#:
Site Plan Name:
Project Name:
Setbacks Front Back:
.
Fle_S4 MCV(_�' 't'Y,(- "
le t-oo-
F]HVAC F]Gas Tank [:]Gas Piping
Electric 0 Plumbing OSprinklers
Total Sq. Ft of Construction: sor-a—
Cost of Construction: $
Address: L0.
City: _16EIL State: EL
Zip Code: Fax:
Phone No.':)-)-a�
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Lot No. 12-
Block No.
Left Side:
Dnd re-Voce
V-00-P
Ft. of First Floor:
]Sewer[—]
Septic
Building Height:
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
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phon
_ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Jamie Cisco
Address:
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: PO Box 1083
City:
Zip: Phone:
City: Palm City State.
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
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 your Notice of Commencement.
SIkAature of Owne / Lessee/Contractor as Agent for Owner
Signature of Contract/License Holder
STATE OF FLORIDA
STATE OF FLORID
COUNTY OF--�
COUNTY OF
Th instr n s acknowled efore me
Th g instr w s acknowledg fore me
thi y of 20t' y
thi Bay of V" 20 y
R �
1
R
I
Name of person making statement
Name of perso king statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type o n ' tion
Type of Identification
Produce — r
Prod ed
(Signatu
Signature of Not`d ' i .tat#GG9392�
-
Y
Commiss
2
iU i*= MYCOMMMION#fiiq
:*
='� EXPIRES: m r11,23
Commission No. '' Undermftm
�. j
•%1?fie.,
T,ruR
y
45 lard! rublii`U bta
;y 1.� Public
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17