HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONF'
� � r
APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r�1
te:TlI�li Permit Number: IR��1r ��
UANNED
- -- Building Permit ApplicationCOP
ing and Development Services
ng and Code Regulation Division
Virginia Avenue, Fort Pierce FL 34982
e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
P5RMIT APPLICATION FOR: Roof " '
906 Nettles Blvd. Jense Beach FL
I Description: Nettles Island Inc a Condo- Section II Parcel 906 and Pro-rata share in common elements
Z 3933-1934) 906 Nettles Blvd Jensen Beach FL
ierty Tax ID #.. 4502-501-1092-000-9 Lot No.
Plan Name: Block No.
act Name:
Jacks Front Back: Right Side: Left Side:
existing shingle roof and install new metal roof
JHVAC L J Gas Tank
IElectric 0 Plumbing
Sq. Ft of Construction: 864
of Construction: $ 6100
3ermit — cnecK au inai apply:
Gas Piping _ Shutters
Sprinklers 11 Generator
S . Ft. of First Floor: _
Utilities: U Sewer F]Septic
1] Windows/Doors
DRoof 3/12 Roof pitch
Building Height: 8'
IN
th
WIN
Na
e Bernard Minville/Julie Plante
Name: Jamie Cisco
116 rue du Chealier de Chaumont
Ad
Company: Sunshine Roofing LLC
�ess:
Carignan, QC J3L 358 Canada State: _
Code: Fax:
City,,
Zip
Address: PO Box 1083
City: Palm City State: FL
Phone
No. 418-575-9950
Zip Code: 34991 Fax:
E-
IIail: ju'lie_plante@yahoo.com
Phone No. 772-260-8195
ip fee simple Title Holder on next page ( if different
Fill
E-Mail: sunshineroofingllc@gmail.com
State or County License: CCC1327796
fro
the Owner listed above)
7
1 11 If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirea.
M 121
N� �� �/� ,,
ME
ISS -MW-mffl
- �
U
SIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
N
me:
Name:
�
dress:
Address:
State:
City:
City: State:
Z
p: Phone
Zip: Phone:
F
E SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
me:
Name:
dress:
/�
Address:
C
ty:
City:
Phone:
Zip: Phone:
Z�:
OV INER/ 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. ucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
wh ch is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
stri cture. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In nsideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in cordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
Thl following building permit applications are exempt from undergoing a full concurrency review: room additions,
ac ssory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
W RONNG TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
imrovements to your property_A Noticepf Commencement must be recorded and posted on the jobsite
be ore the first inspection. If inten o obtain financing, consult with lender or an attorney before
rn manrina "mrir nr rornr a vni it tires of rnmmPnrPmPnt_
Sinature
of Owner/ Lessee/Contractor as Agent for Owner
Signatu of Contractor License Holder
S
ATE OF FLORIDA
STATE OF FLORIDA
LINTY OF St Lucie
COUNTY OF St. Lucie
T
t
e forging Instrume t was acknowledged efore me
is � day of b� 201by
The forgoing instr me t wa acknowledg efore me
this IPIP day of m 'e,C 20 by
m r ` VA P_'
Jamie Cisco
Name of person making statement
Name of person making statement
P
rsorially Known OR Produced Identification ✓
Personally Known x OR Produced Identification
Type
of Identification
Type of Identification
P'foduced
C eYLS
Produced
(
ignat If a of Notes Pu I
(Signa re of Not
Notary Public State of Florida
No. MariWldi egel
r�-0yPLo� Notary Public State of Floridammission
Commission No. oMarilyn Klueg eal)
c: > c� My Comrnission FF 230179
C-4- c My Commission FF 230179
'koF d¢' Expires 06/28/2019
1sof �yoe' Expires 06/28/20 99
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
CEIVED
PATE
MPLETED
8/2/17