HomeMy WebLinkAboutBuilding Permit Application ALL APPLI BLE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n
Date: Permit Number: V
_• 1
Building Permit Application APR 2 3 2021
Planning and Development Services Fwr-fliftk'lg Department
Building and Code Regulation Division 5 ; L-ude County
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: 1295 Re n ne++ 2d P4• Pierce . FL 31A417
Legal Description: 13 35 3G N 7 W4 24 o-P E ' I-?- n P Sr_ ' I LI n E IV E ' ICI" IeSS EJ 30-P+-
QhC( E115A+ af- N Z. Ac''of- SS4C. 6f- W '1-LoP E ' 1z. rFKiW ' 1yoFtitr 'Iq b-5z,
Z,Property Tax ID#: 3 1 E` (Z`4 — 0001 -WO-6 Lot No.
Site Plan Name: Block No.
Project Name: A n_ hOng ('nnn n_-
Setbacks Front Back: Right Side: Left Side:
$®ETAILED DESCRIPTION OF�,WORK:
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remove exls4lnq ski I�Ie- ro -P and r-ePlc3ce— wr+ h
CONSTRUCTION IN'FORIVIATIO'N
Adclitional work to eperformed under t is permit—c. ec a apply:
11HVAC Gas Tank Gas Piping 11_Shutters ❑Windows/Doors
Electric 0 Plumbing Sprinklers [Generator Roof Roof pitch
IN
Total Sq. Ft of Construction: '` 1°' J S . Ft.of First Floor:
Cost of Construction:$ Z , 5L4 0. Utilities: _SewerEl Septic Building Height:
OWNER/LESSEE:- CONTRACTOR:
Name On nan+ Name: Jamie Cisco
Address: I7_g6 Anne N- ICI Company: Sunshine Roofing, LLC
City: P-4-. Pierce. State: F-L Address: PO Box 1083
Zip Code: 34gL4 9 Fax: City: Palm City State:FL
Phone N Zip Code: 34991 Fax:
E-Mail: Phone No. 772-260-8195
Fill in fee simpleqltle 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,083 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 recording our Notice of Commencement.
ign ture of O er/Lessee/Contractor as Agent for Owner Signature of Cont ctor/License Holder
STATE OF FLOR STATE OF FLORI1t s ���\�
COUNTY OF C�� COUNTY OF
The r g instru ent wad acknowledged before me Th gQ' instru nt was cknowledged efore me
thi;� of 20 by thi f 20 �by
cc
Name of per o making statement Name of person m rig statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produc Produced
(Signature of No ' •11` c+�State o (Signature of Notary on )
rys'= MYCOMMYE rr'e
Commission No. F .,. IXPIItEg;MAIGG93M
Commission No. 5•t : : YCOMMI��PYE
Th Nr 11,Z023 �: �" EXPIpCn ON `'C'939200
N YPubpcUfld9n..0 f�FFI��`' �W:DeOelnber 11,2023
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGRO
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17