HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ���' �� ! Permit Number:
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IVED
Building urn Applicatio 0 2018
Planning and Development Services
Building and Code Regulation Division nty, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 i Commercial Residential X
I PERMIT APPLICATION FOR: RoofI I
Address: 2115 Nettles Blvd Jenssen Beach
Legal Description: Nettles Island Inc A condo section 1 parcel 115 and pro-rata share in common elements (OR 1162-239)
Property Tax ID #: 4502-501-0118-000-1
Site Plan Name:
Project Name:
Setbacks Front Back:
Remove existing shingle roof and install new
Iditional work to bjepejrtormed u
0HVAC L_I Gas Tank
Electric E Plumbing
Total Sq. Ft of Construction: 1162
Cost of Construction: $ 10250
Lot No.
Block No.
Right Side: Left Side:
roof
'CLR a " U
a PipingShutters Windows/Doors
Sprinklers 0 Generator Roof 3
Sq. Ft. of First Floor: _
Utilities:0Sewer Septic
Name Roger & Jane Bolhouse
Address: 6154 Pebble Dr.
City: Allendale State: MI
Zip Code: 49401 Fax:
Phone No���772 — 02
E-Mail:b�
Fill in fee sinitple Title Holder on next page ( if different
from the Owner listed above)
Name: Jamie Cisco
Building Height:
Roof pitch
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@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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_ Not Applicable
DESIGNER/ENGINEER: _ 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:
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 p;ior 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
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Signature of Own / Lessee/Contractor as Agent fob Owner
i
Signa re of Contractor/license Holder
STATE OF FLOTAL,
STATE OF FLORIDA
COUNTY OF VI
COUNTY OF St. Lucie
The f ing instrument was acknowledg before me
this 'day of R� brt� 20 by
The fo ing instryLne�,nnt was acknowledge fore me
this °day of cabrua 20J e by
sr
-J—am�ie_
N me of person making statement
✓
Name of person making statement
X
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced i C° e_r)
Produced
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CnIal r_�, L�L�
(Signat re of Not a
(Signature of Not -SIR
nr o!/
oyn Notary Pub' (pSate of Florida
Commission No.Marilyn KI�
1wQY °ua Notary Public State of Florida
° I n Klue seal
Commission No. ; y
oe My Commission FF 230179
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o� MY Commission FF 230179
OF F�°�` Expires 06128/2019
�OF F�°Q Expires 06/28/2019
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17