HomeMy WebLinkAboutBuilding Permit Application1 � `
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11 3 Permit Number: V1 I
Building Permit Applicat
R-:ECEIVED
Planning and Development Services NOV 0 3 20V
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 artment
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial plafgtirW P FL
UGie
PERMIT APPLICATION FOR: Roof -
Address: 3191 Daniels St. Fort Pierce, FL 34981
Legal Description: White Cty S/D 05 36 40 from NW cor Lot 99 Run E 25 Ft th s 530 ft, th E 2685 ft. for POB th conte 120 ft.
th S 130 ft, th W 120 ft. th N 130 ft to POB (40-A)(0.36 AC) (Map 34/05S)(OR 675-1023)
Property Tax ID #: 3403-502-0187-000-1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Remove existing shingle roof and replace with Standing Seam Roof Q nd f[q .
411-"�'
iaitionalwork tobe
11HVAC
11 Electric
nertormea
0
unaertnispermit— cneckall
Gas Tank Gas Piping _
Plumbing Sprinklers
apply:
Shutters Q Windows/Doors
Generator Roof
0
Total Sq. Ft of Construction: 1136
Cost of Construction: $ 10250
S Ft. of First Floor: _
Utilities: Sewer El Septic
Building Height: 8'
OV1%NEF%LE�SSE=E ;'
A\ J 4 w t G h1 re3 a
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C®NTRACT®R�
Name Roberto & Rebecca Rivas
Name: Jamie Cisco
Address: 3191 Daniels St.
Company: Sunshine Roofing, LLC
City: Ft. Pierce State: _
Address: PO Box 1083
Zip Code: 34981 Fax:
City: Palm City State: FL
Phone No. 772-577-0307
Zip Code: 34991 Fax:
E-Mail: rj723@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 or County License: CCC1327796
iT value oT construction ss tizsuu or more, a KKUKDED Notice of Commencement is required.
SIJPPPLEIYIENTAL� �ZONSTRUGTION�LIENL�AWINFOR41VllTl
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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:
City:
Address:
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 vour Notice of Commencement.
Signature of Owner/ / Lessee Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Vo a!+ +n COUNTY OF MA f)
The forming instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Cf day of 0m Je vr► ioef" 20 A by this day of n b ✓ e_m b Q-e— , 20—LT by
Q"\P)DP_CCQ_ R,%%JCLS Jamie Cisco
(Name of person acknowledging) (Name of person acknowledging)
'Mo KL"O-
(Signatu a of Notak Public- St to of FloAda (Signat a of Not Public- Stbte of Flo i a
Personally Known OR Produced Identification X Personally Known X OR Produced Identification
Type of Identification Produced License Type of Identification Produced
Commission No. ommission No. Notary P ate of Florida
ao ou�n N ry Public State of Florida o G
Marilyn Kluegel ° Marilyn Kluegel
v 30179 M Commission FF 230 79
le
�f► Expires 06128/2019 c a Expires 08/28/2019
Revised 07/15/2014
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
RE)EW
REVIEW
REVIEW
REVIEW
DATE
Q
COMPLETE
INITIALS