HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 3-24-21 ALL APPLICAB
LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: Permit Number: 0�2_ )
'RECEIVED
Building Permit Application
Planning and Development Services APR 2 3 1011
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 F:rk g apartment
Phone: (772)462-1553 Fax:(772)462-1578 Commercial ResidentialSX Lu"'cou,r,
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: �P403 Ar-eca Pqlrn Dr- Fir- . P► eme, FL 34gR-L
Legal Description: l ade. 1—
( otk qZ'1 -
PropertyTax ID#: ZL43e-I RUZ'OQZS "CW+_-5 Lot No.
Site Plan Name: Block No.
Project Name: 's4 k �q r�
Setbacks Front 'Pack: Right Side: Left Side:
DETAILED DESCRIPTION'OF.WORK:
f�►'nOv� �X i 5�1 S I n I'00 O n
CONSTRUCTION INFORMATION:
itiona wor to e e orme under t ispermit—check a apply:
11HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing ❑Sprinklers FI Generator Roof Roof pitch
Total Sq. Ft of Construction: 1 S . Ft.of First Floor:
Cost of Construction:$ 1 Z Jam-0, Utilities: _Sewer E]Septic . Building Height:
OWNERAESSEE: CONTRACTOR:
Name o.-- r- r-, C + n Name: Jamie Cisco
Address: ()g C- t— Company: Sunshine Roofing, LLC
City: F+ —Pfe_rce State: FL Address: PO Box 1083
Zip Code: Faax: City: Palm City State:FL
Phone No. 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 lass 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 inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Sig/
ig ature of ner/Lessee/Co actor as Agent for Owner Signature of Cont ctor/License Holder
STATE OF FLORIDA STATE OF FLORIDA �'
COUNTY OF t-� v� COUNTY OF �C� q-N
The r ing instr ment wa acknowled efore me T d or g instr ent was a�Cknowled Wore me
this ay of 20 �by th y of 1� 20 C �by
l
Name of rson making statement J Name of person ing statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificatio Type of Identification
Produced Produced
(Signature of Notary Public-Sta of F rida) (Signature of Notary Public-State of rl )
Commission KRISTIE06I) Commission 040"X'" ISTIED ea
-14 '* ' ,;_ MY COMMISSION#CMG 939200 ... .* MY COMMISSION#GG 939200
=•�. ate= EXPIRES:December 11,2023 ; ��,°`= EXPIRES:December 11;2023
Ae
ers
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
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DATE
COMPLETED
Rev.8/2/17
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