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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �b 1a� `�� Permit Number: 11 1 0 — a 5,1
Building Permit Application RECE I
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 O C r 2 4 2017
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Resi ep��I x
PERMIT APPLICATION FOR: Roof .p St. Lucie Count F
r
Address: 649 Nettles Blvd Jensen Beach
Legal Description: Nettles Island Inc, A Condo -Section 11 Parcel 624 and Pro
Property Tax lD #• 4502-501-0810-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side:
Left Side:
Remove existing shingle roof and replace with new metal roof
E1HVAC U Gas Tank ❑Gas Piping
0 Electric D.Plumbing Sprinklers
4 I Ia,
Shutters Windows/Doors
Generator Roof
Total Sq. Ft of Construction: 1000 So. Ft. of First Floor:
Cost of Construction: $ 6500 Utilities: O Sewer Septic Building Height: 8
Name MichOW & JIII`Cdey
Address: 624 Nettles Blvd
City: Jensen Beach State: _
Zip Code: Fax:.
Phone No. 781-454-6740
E-Mail: jillcarey77@gmail.com
Fill in fee simple Title Holder on next page ( 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. 772 460-8195
E-Mail: sunshineroofingllc@gmail.com
State or County License: CCC1327796
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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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 gr 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.
0 P, ea
Signatur o Owner ' ent/ Lessee
Signature of Contractor/License Holder
STATE OF FLQRIDA� r` STATE OF FLORIDA
COUNTY OF COUNTY OF ffNo.rVl r)
The forgoing Instrument was acknowledged ikefore me
this day of 6 (. Ober 20 1 by
i �, l 0 C-t-e- P
(Name of person acknowledging)
(Signature o Notary Public- Stati of Florid )
Personally Known
Type of identification Prod
Commission No. -
Revised 07/15/2014
OR Produced Identification X
The for oing instrumeRt� as acknowledged before me
this Zdayof ('i";T(1 r .20_ffby
Jamie Cisco
(Name of person acknowledging)
(Signatu a of Notaj P blic- Pate of florida )
Personally Known X r i
Woe of Identifieation P u a/�Ia_M Finrida-
II���ll�qq Kluegel I mmission No.
My0 mission FF 230179
Expires 06/28/2019
Marilyn Klue el
My Com� FF 230179
Expires 06/2e/ 019
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