HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONL
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3i2/18 CJ Permit Number:
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8V � /RECEIVECiBuildi0191P rt�`�►pplication I
Planning and Development Services MAR 3 0 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ` ST. Lucie County, Permitting
Phone: (772) 462-1553 Fax: (772) 462-1578� Commercial Reside
PERMIT APPLICATION FOR: Roof
Address: 2080 Keen Road Ft Pierce, FL 34946 ,
Legal Description: Harmony Estates BLK B Lot 3 (QR 759-1759: 1200-1287)
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Property Tax ID #: 1431-702-0025-000-3
Site Plan Name: Jackson Residence
Project Name: Jackson Residence
Setbacks Front Back: _
Remove shingle roof and replace with 5V metal,) ,
bo-se shy c,nJ rnoehVied Caf Ghee,4
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Left Side:
Lot No. 3
Block No. B
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Additional work to be nertormed under this permit— cneCK all apply:
❑HVAC0 Gas Tank []Gas Piping _ Shutters ❑ Windows/Doors
❑ Electric ElPlumbing[]Sprinklers❑ Generator W1 Roof 5�12 Roof pitch
Total Sq. Ft of Construction: Sl OCj S . Ft. of First Floor 5/(7i�
Cost of Construction: $ _ Utilities':�Sewer ❑Septic Building Height: 8 ft
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OW,NEft/LESSEE:CONTRAC¢T®R
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Name Charles Jackson
Name: Jamie Cisco
Address:2080 Keen Road
Company: Sunshine Roofing, LLC
Address: PO Box 1083
City: Ft Pierce State: FL
Zip Code: 34946 Fax:
City: Palm City State: FL
Phone No. 772-905-7487
Zip Code: 34991 Fax:
E-Mail:
Phone No. 772-260-8195
1
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 L, CONSTRUCTION lI N AVI/
INFORMATION:
DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: Charles Jackson
Name: Jamie Cisco
Address: 2080 Keen Road Ft Pierce, FL 34946
Address: 2080 Keen Road
City: Ft Pierce
State:
City: Palm City State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Not Applicable
BONDING COMPANY: Not Applicable
Name:
��
Name:
Address: PO Box 1083
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 your Notice of Commencement.
Signature of Ow r/ "see/Contractor as Agent for Owner
Signat of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ,S4 L uCi a
COUNTY OF
The for o'ng instrurvent was acknowledged before me
this ay of I , ra� 20L by
The f r oing instrument w s acknowledge efore me
thisom day of 1'Y}-�r, 20_ by
rle-r, VC�.Cksor
m e ( s2
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification !�
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced %Creh'
Produced
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(Signatu a of Not I' - F o i
(Sign ture of N ary i
Y olFkY pVB� of
Notary Public Florida
Commission No. 4 , .lyn Kluep
=o+Py'Lei^ Notary Pubi c Ste of Florida
Commission No. Marilyn Kl a
N� 9�N c My Commission FF 230179
OF Expires 06/28/2019
� MY Commission FF 230179
Expires 06/28/2019
F�o�
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17