HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: I L7ycp9 a P 7
Building Permit ApplicLPermitting
FEB 12 2H
Planning and Development Services Depd
Building and Code Regulation Division2300VirginiaAvenue,FortPierceFL34982 CIe COUI7
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial R
PERMITTYPE: RerOOf SCANNED
PROPOSED INPROWMENT LOCATION: 11460 le Un 'y'
Address: 10725 S. Ocean Or #214 Jensen Beach, FL
Property Tax ID #: 4511-501-0203-000-2
Site Plan Name:
Project Name:
DET IID DESCRIPTION OF WORK:
Remove existing shinale roof and install new metal roof
Lot No.
Block No.
CONSTRUCTION INFORMATION; t j
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: � ] toO Sq. Ft. of First Floor:
Cost of Construction: $ WrAo Utilities: —Sewer _Septic
Windows/Doors
_Roof &2, Pitch
Building Height: 2 f
OWNER/LESSEES
CONTRACTOR: m .
Name Jacques Hansen
Name: Jamie Cisco
Address:607 Cloutier
Company: Sunshine Roofing LLC
City: St Faustin Lac Carre State: _
Zip Code: JOT1J2 Fax:
Phone No. 772-214-8384
Address: PO Box 1083
City: Palm City State. FL
Zip Code: 34991 Fax:
Phone No 772-260-8195
E-Mail:j-g-hanW@hotmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Address:
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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or anscovenants 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
rnmmanrino work or rernrdine vour Notice of Commencement.
Sig ture f Owner/ LLPeessee/Contractor as Agent for Owner
Signature of ContraHolder
T
STATE OF FLctor/License
CO TYOFL-itLLk)e
COUNTYOFTTLucle
The r to instru�ae t was acknowled a before me
g �aeqq g
The f r oing instrument was acknowled ed before me
by
this. day of f—Et7irt 20 by
thisydayof Fpl7f�2
& Il2e; n Sern
Jamiecism
Name of p son making statement.
Name of person making statement.
Personally Known OR Produced Identification ✓
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signat re of Not Public- S to of Flo da)
(Signa ure of N aryPu to of Florida )
vn
Commission No. °k NotJ§J* IlC state of Florida
o'v'o¢ Notery Byy¢¢LLs fate of Florida
Commission No. + MarlyntkTueel
Marlyn Kluagel
My Commission FF 23
A• My Commission FF 230470
s
2019
REVIEWS
FRONT
PLANS
VEGETATION
SEATURTLE
MA
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.9/26/18