HomeMy WebLinkAboutBUILDING PERMIT APPLICASTION�
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ALL APPLICABLE INFO
/•MUST BE COMPLETED FOR AURWC GUN TO BE ACCEPTED
Date: � Z`' l BY Permit Number: / Y 0z —
. - St Lucie County
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553' Fax: (772) 462-1S78 Commercial
PERMIT APPLICATION FOR: koof
Address: 8201 Indrio Rd. Ft Piere, FL
RECEIVED
MAY 0 4 2018
ajina Department
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Legal Description: 14 34 39 From NE cor'of N 1/2 of NE 1/4 of SW 1/4 run W alg 1/4 sec LI 80 FT, TH S 20 Ft.
TH W 331.31 Ft to POB. TH Cont W 60 Ft. TH S337.64 Ft Th W 140 Ft TH E 200 Ft. TH N 637.64 FT to POB
Property Tax ID #: 1314-311-0011-000-2
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side:
Remove existing shingle roof and replace with new metal roof
1
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11 Electric 0 Plumbing❑Sprinl
Total Sq. Ft of Construction: cz T'��/' 0 o
Cost of Construction: $ Ya L2,0
Left Side:
Lot No.
Block No.
QWindows/Doors
,��
Roof Roof pitch
S�Ftj of First Floor:
Utilities: L_JSewer L;JSeptic Building Height:
i ..
Name Dominick A Kopelakis
Address: 8201 Indrio Rd.
City: St. Pierce, State: 'FL
34951
Zip Code: Fax:
Phone No. 772-267-5584
E-Mail: dkopelakis@slwsd.org
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
IIf value of construction is $2500 or more, a RECORDED Notice of Commencement is required. I
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MORTGAGE COMPANY: _
Not Applicable
DESIGNER/ENGINEER: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City:
State:
Zip: Phone I
I
Zip:
Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address: I
Address:
City: I
City:
Zip:
Phone:
Zip: Phone: I
I
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
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Si a of Own / Lessee/Contractor as Age it for Owner
Signature of Contractor/License Holder
STATE OF FLORID i
STATE OF FLORIDA
COUNTY OF l5 LuCCte
COUNTY OF St. Lucie
The fo going instrument was acknowledge before me
this day of C 20 byl
The fo oing instrument was acknowledge efore me
this day of 20LKby
Name of person maki g statement
Name of person making statement
Personally Known OR Produced Identification i"_
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced i 0-ense- I
Produced
� �
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o
(Signat re of Nota ublic- Slate of Flori a }
i
(Signat re of Not ryi - tate of FI rida )
Commission No. a
NotaryPublic Late of Florida
pY PVO Notary P�p
Commission No. r 4 ate of Florida
Marilyn Ftluegel
ao Marilyn Kluegel 1
v , yN` My Commission FF 230179
Icy �6f11misslon FF 230179
OFF" Expires 06/28/2019
REVIEWS
FRONT
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17