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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 - Permit Number. 0 05:1a�)
SCANNED
BY RECEIVED
e
St. Lucie County MAY 1 3 zu19
- - -- Building Permit Application Permitting Department
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: ROOf
PROPOSED INPROVEIVIEIVT LOCATION s
Address: 10725 S. Ocean Dr Lot#125 Jensen Beach
Property Tax ID #: 4511501-0357-0006
Site Plan Name:
Project Name: Rispoli House
Remove existing shingle roof and install new standing seam roof
Lot No.21
Block No. L
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof 7/12 Pitch
Total Sq. Ft of Construction: / noo Sq. Ft. of First Floor: /000
Cost of Construction: $ !f"] W Utilities: —Sewer _Septic Building Height:
Ol(11NERfLESSEE.
x a
Name Mike Rispoli
Name: Jamie Cisco
Address- 10725 S Ocean or #125
Company: Sunshine Roofing LLC
City: Jensen Beach State: _
Zip Code: Fax:
Phone No.561-758-1161
Address: PO Box 1083
City: Palm City State: FL
Zip Code: 34991 Fax:
Phone No 772-260-8195
E-Mail: mfretiredl0@comcast.n et
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 or Lommencemenc is requuea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
,SUP,PL"EMENTAL
CONSTRUCTION L1EN,LAWINFORMATI,ON
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DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
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 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 toN btain financing, consult with lender or an attorney before
rnmmunrino u,nrlr nr rcrnrdino vnur rP of rnmmanrPmPnt_
Signature of Owne ctor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLO QQA
STATE OF FLORIDA
COUNTY OF Tt Luct e-
COUNTY OF
The for oing instrument was acknowledg before me
The for Ding instrument was acknowledg before me
204 by
this day of 20 by
th e day of �
ffl C 1
Jamie Cism
Name of person makillngstatement.
Name of person making statement
Personally Known OR Produced Identification ✓
Personally Known x OR Produced Identification
Type of Idegtification
I `�yISQ
Type of Identification
Produced
Produced 1
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(Signa re of No ry ubli .5 ate R$ rjState o} Florida
(Signa re of No ry P , y$ to car u�l c Stata of Florida
5 0p 9 o
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° Marilyn Kluegel
Commission No. v My Com19 p FF 230479
dd__6,18122019
ry
;4 % Marilyn Klueg I
Commission No. �y� My Comn{5931 F 230179
e�F° Fxplres
°rHo' Expires 06/28/2019
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Rev.9/Zb/18