HomeMy WebLinkAboutBuilding Permit Application ALL APPLI AB E IIVO YUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 0
Date: Permit Number: IOb r S 2_4
RECEIVED
•
Building Permit Application JUN 17 2021
Planning and Development Services St.Lucie County
Building and Code Regulation Division Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
JP:eROPOSED'IMRROVE•NIENT-LOCATION:
Address: 14410 Arco Po l m Dr- Ebr -+ Pi t ree, r L 34q g z
Legal Description: ,i r-c I Liri l Q l QU e-S BL(C 4 LOY S-
Property Tax ID#: IIZ43 4 - qO Z -W Zq 'C0O .O Lot No. 5
Site Plan Name: r f(�CY1P� son P r-S Block No.
Project Name: S--C.4
Setbacks Front Back: Right Side: Left Side:
DETAILED,,DESCRIPTION OF
mmve ex S 4- i Y1q l n, O e roof c-x r\d reP(c tce
� l rp' `":r laii'rs RAW)
get. - �ra z;tw`?i'"� •' :,�k t.f���s'
CONSTRUCTIONIN�F�®�RMA�TI®N � ��� _ �;�
itiona workto e e orme under this permit-c ec� a. ,apply:
nHVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doo s
11Electric 0Plumbing []Sprinklers ElGenerator Roof I� Roof pitch
Total Sq. Ft of Construction:- E S . Ft.of First Floor:
Cost of Construction:$� .�C) Utilities: _Sewer E]Septic Building Height:
OWNER/LESSEE. CONTRACTOR. .:.
Name nmes S�o n r-S Name: Jamie Cisco
Address: L4410 Prf'_cc Po ( ri, n r- Company: Sunshine Roofing, LLC
City: PI e�r e_ State: Address: PO Box 1083
Zip Code: q_3q 8 Z Fax: City: Palm City State:FL
Phone No._ 1� - - 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$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name: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 i tion. If you intend to obtain financing, consult with lender or an attorney before
commencing w or recording our Notice of Commencement.
ignat r ol Owri r/Lessee/Contractor as Agent for Owner Signature of Cont cctor/License Holder
STATE FLO ID STATE OF FLORI`'`�.�"'IV�
COUN F (1 COUNTY OF
Th ing instnt was acknowled�� efore me T g instru ent was acknowled e
rul e fore me
this y of 20_ by thi day of 20 �y
Name of person making statement Name of person statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificat Type of Identification
X!X!57
Produced
me
(Signa (Signature of Notary Public-Sta rida)
vn��u KRISTI
Comm' :u¢*,�.z
*: MY COMMISSION#GG 93 I Corn
ecember 11,2023
BondedThNNotary Public Undetwrtiters ?oe: KRISTIEDYE
#r MY COMMISSION#GG 939200
ecember 11,2023
REVIEWS FRONT ZONING SUPERVISOR PLA ° oe, N rs MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIE KtVItW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17