HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COM.,__rED FOR APPLICATION TO BE ACCEPTED j.
Date: 3- 0 - % "/]. Permit Number:
Building Permit Applicatioi
Planning and Development Services i p,
Building and Code Regulation Division L
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Reside
(� 1 le,
PERMITTYPE: RerOOf SCANNED
PROPOSED INPROVEMENT LOCATION:BY;
'itaa-,...... 10951 S-Ocan Dr $418 .lensen Reach_ FL UCIe -OUi1 y
e
Property Tax ID #: 4511-810-0023-000-5
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Remove existing shingle roof and install new metal roof
Lot No.
Block No.
CONSTRUCTION INFORMATION:1 I ` ` t
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: 1000 Sq. Ft. of First Floor: _
Cost of Construction: $ 5250 Utilities: —Sewer _Septic
—Windows/Doors
Roof 3/12 Pitch
Building Height: 8'
OWNER/LESSEE:
CONTRACTOR:
Name Kenneth H Adams
Name: Jamie Cisco
Address: 10851 S Ocean Dr #16
Company: Sunshine Roofing LLC
City: Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No.740-503-8668
Address: PO Box 1083
City: Palm City State: FL
Zip Code: 34991 Fax:
Phone No 772-260-8195
E-Mail: khadams2@yahoo.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.
DESIGNER/ENGINEER: -jr _Not
Name:C
Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Addres > i
nb a
Address:
City:
Zip: _ Phone tf Z
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
SUPPLEMENTAL CONSTRUC v LIEN LAW INFORMATION:
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
commencingwork or recordingour Notice of Commencement.STATE
Signature of Owner/ LQQessee/Contractor as Agent for
OF
ev.
,a
Owner
Signature of Contract/o�r/License Holder
Lu��l�
COUNTyOF��DLUCI�
COUNTY OFO9
The for oing instrument was acknowledg before me
The forgoing instrument was acknowledged before me
� ftrC h
this day of 201� by
this day of , 20_ by
Jamie Cisco
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification �
Personally Known z OR Produced Identification
Type of Ida t4fication
Type of Identification
Produceda /�e'� S�
Produced
i
(Signal a of Nota Public -Sate of Fla ida)
(Sign ure of No ry ��;, k Notary ubllc sate of Florida
Wlo"N,otary rate of Flonae
Commission No. (�4J5
Madlyn KIU ggel �9,
Commission No. My Commis�ACigK30.97a
arilyn Kluegel
or no zplres 0a/2812a99
y Commission FF 230.979
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED