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HomeMy WebLinkAboutsouth park garage APPALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: (91) Permit Number: Planning and Developmenr 5ervices Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential I PERMIT APPLICATION FOR: Roof I Address: Legal Des Property Tax ID #: Lot No. J­ Site Plan Name: Project Name: Lt&±fjQiV1S6Y_) Setbacks Front Back: Right Side: Left Block No. tUtA_.OV,�_ SW t3j , r Vd'A rA &L44C, I ACICIttionaiwor!<Woeperrormeo unaertni!iperittit—i-iit:trciiincilipty- 1]HVAC Gas Tank [:]Gas Piping Shutters Windows/Doors Electric Plumbing []Sprinklers Elenerator Z Roof Roof pitch cc�2e Total Sq. Ft�3 of Construction: ,c_) S i. Ft. of First Floor: j, Cost of Construction:$ UtilitiesIn Sewer FI Septic Building Height: Address:Ig":fflt-,,S_/V0_.0,n QYAL- City: -I, eonru b4,&,e &CA State: f, Zip Code: 3V4:j5'7 Fax: Phone CL35-7 E-Mail: WbIr h'v.S1.1Ju h 6) Fill In fee simple Title Holder onnextpage (if different from the Owner listed above) Name: Jamie Cisco Company: Sunshine Roofing, LLC Address: PO Box 1083 City: Palm City State: FL Zip Code. 34991 Fax: Phone No. 772-260-8195 E-Mail: sunshineroofingllc@gmall.com State or County License: CCC1327796 If value of construction Is $2500 or more, a RECORDED Notice of Commencement Is required. DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name; Jamie a — Address: Address: City: PalmC,ity State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: __,_Not Applicable Name: Name: Address: Address: Po B-1m 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 andcovenantsthat 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 work or recording vour assent for owner STATE OF FLORIDA COUNTY OF Vie t -i- i n The forgoing instrument was acknowledged before me this -ZH achy of �, }i •4-c, 1,N t- 20Z1 by 1 C�rCYI�t; CC Name of person making statement Personally Knownr. OR Produced identification Type of Identification Produced re of Signature of Con or License Holder STATE OF FLORIDA COUNTY OF f-f-i t ; r_I ! in The forgoing instrument was acknowledged before me this 77iiay of i (40 ke t 20 Zi by jl n-i i ' t SC G _ Name of person making statement Personally Known � OR Produced identification Type of identification Produced of SM - JLE5�5�1aCA KAMPFF r�*° JESSICA KAMPFF � N01d1i10,4 • scate of Florida Commission No. ^s „ •? {�Bilij bilc • State of Florida Commission No. "� Commission HN 1 f plor C mission d hh 106a97 '.'�_ 8C . Gomm. Expires Mar 21, 2025 r`" My Comm; Expires Mar 21, 2025 9e, "through National Nora ^o�Ni through Nalicnai tiotary Asses Y Assn. REVIEWS I FRONT COUNTER I REVIEW SUPERVISOR ZONING REVIEWI REVIEW PLANS I VEGETATIONSEA REVIEW TURTLE I MANGROVE Rev. 8/2/17