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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: i p;;
MAR 0 9 2017
Building pM Permit Application PERtAJTT►NG
St. Lucie Couniy, FLPlanning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 X
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof - ,,,,,, -
PROPOSED IMPROVEMENT LOCATION:
Address: 1036 Nettles Blvd.
Legal Description: Nettles Island Inc, A Condo-Section II Parcel 1036 and Pro-rate Share in Common
Elements (OR 3764-239)
Property Tax ID#: 4502-501-1223-000-7 Lot No.
Site Plan Name: Block No.
Project Name: Thomas Residence
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace old shingle roof with new metal roof.
CONSTRUCTION INFORMATION:.
Additional work to be pertormed under this permit—check all that apply:
HVAC _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator ✓ Roof 4/12 Roof pitch
Total Sq. Ft of Construction: 1,025 Sq. Ft.of First Floor:
Cost of Construction:$ 5,800 Utilities: '—Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Nelson Nelson & Norma I homas Name: Joseph W. Shyder
Address: Company:
2401 Windsor ores r. Seaside Rooting, Inc.
City: Louisville State:_ Address: JackJames r., Unit
40272 rt
Zip Code: Fax: City: Stua State:
Phone No 36 Zip Code: Fax. 283 21
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: joe seas) eroo Ing.net
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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:
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.
I9k;944 '0. s
Signature of orlLessee/C679fractor as Agent for Owner Signature o o c or/ i se Holder
STATE OF FLORIDA STATE O FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of , 20 7by this � day of /6�4,1' z, Ll .20 _L7 by
Gf/ may,
(Name of pefson acknowledging) (Name of persona knowledging)
(Sign aturd�of Notary Public-State of Florida) (Signature of Notary Public-State of Florida )
Personally Known Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
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Commission No. � 5 7 Yu Nate o mission No. �
�Pu�NOfl bnn:. ip �� Notary Public State of a
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FE Gregory E Noll
951 2
i � orri Revised 07/15/2014 ExWre�01/19/2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE n
COMPLETE �, �� ��
INITIALS