HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t� (� l i Q
Date: Permit Number: ( I lJ ( C��l
Building Permit Application
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
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 108515 Ocean Dr,#121.Jensen Beach, FL
Legal Description: windmill Village by the sea condominium No 1 Unit 121 and prorata share in common elements(OR 3912-186)
Property Tax ID#: 4511-810-0128-000-1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove existing shingle roof and replace with 5-V Metal roof
CONSTRUCTION INFORMATION:
Additional work to e nertormed under this permit—check a apply:
1JHVAC Gas Tank Gas Piping _Shutters ❑.Windows/Doors
❑Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 695 S .Ft.of First Floor: 695
Cost of Construction:$ 4300 Utilities:nSewer D Septic Building Height: 8'
OWNER/LESSEE: CONTRACTOR:
Name John Dellacroce Name: Jamie Cisco
Address:108515 Ocean Dr. #121 Company:"Sunshine Roofing, LLC
City: Jensen Beach State:_ Address: PO Box 1083
Zip Code: Fax: City: Palm City State:FL
Phone No.772-353-1612 Zip Code: 34991 Fax:
E-Mail:idellacroce@bellsouth.net 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 o�County License: CCC1327796
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
1
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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.
gnature of Owner/Agent/Lessee Signature of Contrattor/License Holder
STATE OF FLO-RIDA STATE OF FLORtDA
COUNTY OFF 1 )4 Ord COUNTY OF I y C Atin
The forgoing instrument was acknowledged efore me The forgoing instrument was acknowledged before me
this day of,_U l-1_�" 20ff by this W day of,Tune 20_17 by
Ak-110 I^ 0(0. Jamie Cisco
(Name of person acknowledging) (Name of person acknowledging)
(Signat re of Notaky Oublic-I
tate of Flo Ada (Signat re of Nota P blic-St to of Flori a)
Personally Known OR Produced Identification X Personally Known X OR Produced Identification
Type of Identification Produced License Type of Identification Produced
Commission No. °use zk Notar'( OState of Florida Commission No. o�►j1Pks Notary(&7't
rid
Marilyn Kluegel Marilyn Kla� My Commission FF 230179 � MY Commis179
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS