HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE IFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED {r(� _
Date: — J SCANNED Permit Number: 0 bV O
BY
St. Lucie County seceriEo
• - Building Permit Application oct o-.10s
Building and Development Services I rM%6M ode Regulation Division ve St. vq ee�v me^`
9 9Sc.
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XXX
PERMIT TYPE: Re -roof shingles to metal
PROPOSED IMPROVEMENT LOCATION:
Address: 2050 Nettles Blvd., Jensen Beach, FL 34957
Property Tax ID #: 4502-501-0053-000-7
Site Plan Name:
Project Name: Johnson Residence
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I
2 r EL.'t- Sfiic K
CONSTRUCTION INFORMATION:
-Additio?ial work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors
_ Electric _ Plumbi g _ Sprinklers _ Generator � Roof "�rY Pitch
Total Sq. Ft of Cbrt'strfV
ucti'U9Z ' 2�D �a Sq. Ft. of First Floor: �?8
Cost of Construction: $ Q'�0 Utilities: —Sewer —Septic Building Height:
OWNERAESSEE
CONTRACTOR:
Name Charles M & Nancy J Johnson
Name: Bruce W. Watley
Address:2050 Nettles Blvd.
Company: Jupiter Island Roofing Inc
City: Jensen Beach r Stater
Zip Code: 34957 Fax:
Phone No.
Address: 11708 SE Dixie Highway
City: Hobe Sound State. FL
Zip Code: 33455 Fax: 772-223-0684
Phone No 772-206-3353 1 t n-)L- '-vi(Vk
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from, the Owner listed above)
E-Mail jupiterislandroofing wcifl.com
State or County License CCC1327631
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: xx Not Applicable
Name:
MORTGAGE COMPANY: _)�X Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: o Not Applicable
Name:
BONDING COMPANY: kxNot Applicable
Name:
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature of Owner/ Lessee/Contr for as Age or Owner
Signature of Contractor/License Hold Vr
STATE OF
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OF ORIDA ' � •
COUNTYOFORIDA
COUNTY OFSTATE
A
The for oing instrument was acknowledged before me
this �dayof (� ' 20�by
The for oing instrument as acknowledged before me
this2dayof 6CJ� 201Q by
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s Name of person makingate ent.
II
Name of person making stateme .
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identificatio
ProducedT(
Type of identificatio
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- of Florida )
Commission N .�`Y:��?-. ELLEN uARdlkfiN
Commissio f;�VP"',
3 6 e of Floritla-Natary Public
Commission
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