HomeMy WebLinkAboutBuilding PermitALL APPLICAB E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED L
Date: 1 Permit Number:
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Building Permit Application 03/U302d
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
Residential X
PERMIT APPLICATION FOR: Roof
PROPOS E
Address:
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Legal Description: VPn--uI-g r--O+- SeC4Inn
C - Oi- (Z 0R 3q(Dq- "I�J
Property Tax ID #: Z4 51 205 61 Z 9 -eco-
O Lot No.
Site Plan Name:
Block No.
Project Name: Promo no l l l
Setbacks Front Back: Right Side:
Left Side:
DETAILED DESCRIPTION OF WORK: .
I—em�v� exis+trl S �r1 e r-oo on r�_-Pckce
n W 5 met- l roo
CONSTRUCTION FORM IO
Additional work to be�jer orme under this permit - check
11HVAC L_I Gas Tank Gas Piping
❑ Electric ❑ Plumbing Sprinklers
all apply:
Shutters ❑ Windows/Doors
Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ ��j Utilities:
S . Ft. of First Floor:
r
_ Sewer Septic Building Height:
OWNER/LESSE
CONTRACTOR:
Name E f O Ul IQ
Name: Jamie Cisco
Company: Sunshine Roofing, LLC
Address 10r701 socean hr.
City: , nSer\ Re0Ch State: FL
Address: PO Box 1083
City: Palm City State: FL
Zip Code: Fax:
Phone NQ. C2U I-Ot6t. I - UM n
Zip Code: 34991 Fax:
E-MailA
Phone No. 772-260-8195
Fill in fee simple Title He der on next page ( if different
E-Mail: sunshineroofingllc@gmail.com
State or County License: CCC1327796
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
N a m e : Jamie Cisco
Address:
Address:
City: State:
Zip: Phone
City: Palm City State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address: Po Box 1083
City:
Address:
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 vour Notice of Commencement.
Si nature of Owner/ Lesse Co tractor as Agent for Owner
Signature of Contr or/License Holder
STATE OF FLQRIQA
STATE OF FLQRI,DA l
COUNTY OF V-Aci r�\
l-
COUNTY OF -IG,�T��\
The n inst!,t as acknowled before me
this ay of 20� by
Th in instr ment was acknowled efore me
this . y of 20Q�y
Name of person making statement
Name of person rng statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identifi n
Type of I entification
Produc d
Produce
C A
(Sig ry u Florida
(Signature,
�`°
MY COMMISSION # GG 9392
Co :jfsi'�JfPtRE5�l3eeemberll e
Commissi
' "P
;'(�o MY COMMISSION#GG�3g
ber �``��LL�ti
Bonded flxuNotuy�Underwiters
rFoF d�°�' Bonded 7Tru Notary Pubic Under 's
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
MICHELLE R. MILLER, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE # 4862753 OR BOOK 4609 PAGE 1833, Recorded 05/13/2021 08:44:16 AM
AFTER RECORDING -RETURN TO:
PERMIT NUMBER: L This Space is retuned For recording info
NOTICE OF COMMENCEMENT
The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713,
Florida statutes the following information is provided in the Notice of commencement. ,,!
1. DESCRIPTION OF PROPERTY (Legal description and street address) TAX FOLIO NUMBER: Kr I j - �G6 -(-)I Z f? -coo - S-
SUBDIVISION BLOCK TRACT LOT 1 Zr) BLDG UNIT
10901 5 aenn Dr- In+ 9Z6 JPn.enE3Pr,c`h 3gg5r7 Venhore C`u� -Seri-Ino C- II2.'7
2. GENERAL DESCRIPTIOD
3.OWNER INFORMATION:
b.
d. Name and address of fee simple titleholder (if other than owner)
4. CONTRACTOR'S NAME, ADDRESS AND PHONE NUMBER: Sunshine Roofing, LLC 772-260-8195 PO Box 1083 Palm City, FL 34991
5. SURETY'S NAME, ADDRESS AND PHONE NUMBER AND BOND AMOUNT:
6. LENDER'S NAME, ADDRESS AND PHONE NUMBER:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13 (1)(a) 7., Florida Statutes:
NAME, ADDRESS AND PHONE NUMBER:
8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as provided in Section
713.13 (1)(b), Florida Statutes:
NAME, ADDRESS AND PHONE NUMBER:
9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is
specified) . 20
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I SECTION 713.13. FLORMA STATUTES, AND CAN RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY, A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
of Owner or 111J Print Name and Provide Signatory's Title/Office
Owner's Authorized OfCrcer/Director/Partner/Manager
State of Florida
County ofCy� `�j
The ,,foregoing instru ent was acknowledged before me this day of .20 CC
By r as
(Name of person) (Type of authority... e.g. Owner, officer, trustee, attorney in fact)
For
(Name of party on behalf of whom instrument was executed) Personally Known_ or produced the following type of ID: ILA—
...........KRLDYEMY COMMI00(Printed Name of Notary blic) ( gnatureof Notary Public (Seal = ; kXPIi2ES:3TMuNltem
Under penalties of perjury, I declare that I have read the foregoing and that the facts in it are a to the best of my knowledge and
belief (section 92.525, Florida Statutes).
tg ture(s) of Owner(s) or Owner(s)' Authorized Officer/Director/Partner/Manager who signed above:
By: By
Rev. (IM M2007(Recording)