HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABL INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � � Permit Number:
) - o 7V
RECEIVED
illi APR 2 3 2021
Building Permit Application P,rmitting Department
Planning and Development Services St. Lucie Count/
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: ZG 1 JP_PPr_f_U Lone-
Legal Description: CCA rd i na l en t o-l'
Property Tax ID#: Z43(4- go-co I I -00C3-44 Lot No.
Site Plan Name: Block No.
Project Name: U9yQs"
Setbacks Front Back: Right Side: Left Side:
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DETAILS® ®ESCRIPTIONKOFWORK ,
C—emove -e_x uc s+ n skin e �oc� a r c� replace
w44) hew v r,,na l Foo-P
JiCO`�NSTft�CTIONINFORIVII N �
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Additionalwork to e e orme under this permit—check a apply:
11HVAC E]Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric 0 Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: \ S . Ft.of First Floor: I
Cost of Construction:$ gi 50 CC) Utilities:In Sewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name D3 o` I Name: Jamie Cisco
Address: lrq4o rN n UP- 26 Company: Sunshine Roofing, LLC
City: i r State: Address: PO Box 1083
Zip Code: Fax: City: Palm City State:FL
n
Phone No._ 140 - an - Zip Code: 34991 Fax:
E-Mail: -�-- 97> Or .CCy--� I 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.
SUPPLEMENTAL CONSTRUCTION,LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: N am e: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 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 recor ' ou Notice of Commencement. 141
l ure of Owner/Les ee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID /� STATE OF FLORID'
LORID , n
COUNTY OF CIV 1 1t(1 COUNTY OF G��► n t(\
ThWrinstr e t wa acknowled before me Th ing instr ent was acknowledgps Ipefore me
y of 20 1 by thi y of _ 20_ by
e of person making statement / Name of person king statement
Personally Known OR Produced Identification �./ Personally Known O R Produced Identification
Type of Identific tion Type of Identification
Pr u d Produce
9--
(Sign Notary Public-Sta lorida) (Signatur
KRISTIE DYE
Commissi 06 `'�•; IIRISTIEDYE Sea Commissi ti.N ;.: MY COMMISSION#GGIM@Q)
a� MiSS10 4 EXPIRES:December 11,2023
N 939200 Bonded ThN Public Undenvtilen EXPIRES:December 11,2023 `i �
REVIEWS FRONT ZONING b PERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17