HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COIL. TED FOR APPLICATION TO BE ACCEPTER
Date: Permit Number: _ k°(03.0343
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__•_._ _ _. Building Permit Application
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Planning and Development Services SCANNED Q 9
Building and Code Regulation Division BY
2300 Virginia Avenue, Fort Pierce FL 34982Iie bounty
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Resi
PERMIT TYPE: Roof
PROPOSED.INPROVEMENT LOCATION: a
Address: 435 Nettles Blvd Jensen Beach
Property Tax ID #: 4502-501-0621-000-0
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:'
Remove existing shingle roof and install new metal roof
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _Sprinklers
Total Sq. Ft of Construction: 11182
Cost of Construction: $ 8800
_ Generator
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
Lot No.
Block No.
Windows/Doors
Roof
Building Height: 8'
Pitch
OWNER/LESSEE:r ,".:
CONTRACTOR:,,
Name Ronald Ward
Name: Jamie Cisco
Address:939 Nettles Blvd
Company: Sunshine Roofing LLC
City: Jensen Beach State: _
Zip Code: Fax:
Phone No.616-901-2093
Address: PO Box 1083
City: Palm City State: FL
Zip Code: 34991 Fax:
Phone No 772-260-8195
E-Mail: cdward4@gmail.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.
CONSTRULnON LIEN,I,/AW INFORMATION:
Not Applicable I MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
Zip:
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
rommpnrine work or recordine vour Notice of Commencement.
2-Z
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLOgt�A
Cyr LuC r2
STATE OF FLO�I�A
LLet
COUNTY OF
COUNTY OF
The f�rp�oIng instr ent was acknowledg before me
The f r oing instrument was acknowledg before me
this day of f0 20 by
this day of �CCi1 2qJ by
epmU W W, ('�
Jamie Cisco
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification ✓
Personally Known ■ OR Produced Identification
Type of Iden�Yflication
tlCen9�_
Type of Identification
Produced
Produced
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(Signat re of Not ry Public- St to of Flo da)
(Signat Ire of No r Publi State of tiorida )
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°o Nota Public Slate of Fb'
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oj0 °o° Notary Public State7(�t@!MjaCommissi
Commission No.arblic Stl
My Cammisslon FF 230479
o-o' My CommisslonFF
0 o Expires 06/28/2019
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Rev.9/26/18