HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ��, s� � R� Permit Number:'
D� RECEIVED
Building Permit Application MAR 3 0 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
Address: 2080 Keen Road Ft. Pierce, FL 34946
Legal Description: Harmony Estates BLK B Lot 3 (OR 759-1759; 1200-12871
Property Ta:
Site Plan Na
Project Name:
Setbacks Front Back:
Right Side:
Remove shingle roof and replace with 5V metal!,
Left Side:
Lot No. 3
Block No. B
Aaamonal worK Io De errormea unaer tnis permit— cnecK an apply.
0HVAC 0 Gas Tank ❑Gas Piping In OGenerator
Shutters Windows/Doors
L1 Electric 0 Plumbing Sprinklers Roof K— Roof pitch
Total Sq. Ft of Construction: 1500 S Ft. of First Floor:
Cost of Construction: $ 6228 UtilitiesSewer Septic Building Height: 8'
Name Charles Jackson
Address: 2080 Keen Rd
City: Ft. Pierce State: FL
Zip Code: 34946 Fax:
Phone No. 772-905-7487
E-Mail: mrjack64@comcast.net
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. 772-260-8195
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.
I
`�1
NOR RM NON
MORTGAGE COMPANY: _
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 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
rnmmonrina wnrk nr rnrnrriina vniv Nntirp of rnmmanrpmpnt_
Signature of Ow / L see/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLOP IDA
STATE OF FLORIDA
COUNTY OF L f I u6e
COUNTY OF St. Lucie
The orging instrument was acknowledge efore me
this a day of 1�_rdj_-N 120 by
The for�ing instru entt was acknowledg efore me
this day of (C%+' 20 by
C-V)ad es
DQm i�e, isc_6
Name of person making statement
Q
Name of person making statement
Personally Known OR Produced Identification ✓
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced i (r Qn5e--
Produced
11
(Signs ure of No ap d
y i a
(Signature of NotaMAP,.
,'%'y PUB Notary Publi State of Florida
Commission No. r° `'� rilyn KIW)Commission
o� Notary Public to pf Florida
No.a rilyn Klue �a
1- c6 My Commission FF 230179
aQ My Commission FF 230179
9n.',pp F�OQ' Expires 06/28/2019
Expires W/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