HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n ��
Date: 1 Permit.Number:
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Building Permit Application A
Planning.and Development Services �S i�Ing1)
Building and Code Regulation Division t •LudQ C UntY ent
2300 Virginia Avenue, Fort Pierce F134982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof.
Address:
Legal Description: Roo 1-f te— I_o+ 30
Property Tax ID #: 46 0 - .503 -0 36- 000 - G Lot No. 30
Site Plan Name: 1kn I) 0-in I 1 o Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
D,ETAILED!DESCRIPTIO,N.OF WORK
n,
a 45
rnovexis�tn Te roc)-� id replace
L0I �h heuQ �-k le. rooP-
N
,OCONSTR, ION NFORMAT`
Additional work e eormeun under t ispermit — check a apply:
-�
HVAC
Gas Tank Gas Piping _ Shutters ❑ Windows/Doors
ElElectric 0 Plumbing []Sprinklers FIGenerator Roof Roof pitch
Total Sq. Ft of Construction: m S . Ft. of First Floor:
t
Cost of Construction:.$ _z2� 100-60 Utilities: Sewer Septic Building Height:.
OWN'ER�LESS�EE
a s �'"° k.TRACTOiR���aP
.1r..t �i'�i��¢F%�T� .1J
�N
s r y
Name S e i C3
Name: Jamie Cisco
Address: 3Z FQ l C00 I—
Company: Sunshine Roofing, LLC
City: SoU+k6m p �on State: .�LJ
Address: PO Box 1083
Zip Code: 0208g Fax:
City: Palm City State: FL
Phone No. 1c�- -' c� ��—` ��c�-
Zip Code: 34991 Fax:
E-Mail:
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 $2S00 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
N am e : Jamie Cisco
Address:
City: Palm City State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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
commencine work or recoxd-ifig vour Notice of Commencement.
owner[ IAsee/Contractor as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLO�t�pA (� STATE OF FLORIDA L
COUNTY OF �`I Y� �l Ci COUNTY OF Ma d 1 1 C\
Th g instrument was acknowled efore me
thi y of `nl\iJk%lf,/1 , 20_ by
QGa I o
Narbe of person making stat m nt �
Personally Known OR Produced Identification
Type of Identifica0%
M,egtr ment wa acknowledged before me
20� by
Name of person�ing statement
Personally Known ✓ OR Produced Identification
Type of Identification
(Signature of N
ira
KRISTIE DYE
(Signature of
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:;p`�'•"•"
KRISTIED E
'g�9200
Commission No.
I :
MY OMMI5 &OW939200
Commission N *r •.:
MYCOMMISSION
g= EXPIRES: December 11, 2023
5,osv4°P.
.,, o g
S: December 11, 2023
FRONT
Bonded ThruNotary PubneUnderwrflera
ZONING SUPERVISOR
.Oeiy„
PLANS VEGETATION
BondedTIvuNotary Public Undewftem
SEA TURTLE MANGROVE
REVIEWS
COUNTER
REVIEW REVIEW
REVIEW REVIEW
REVIEW REVIEW
DATE
RECEIVED
I COMPLETED
Rev. 8/2/17