HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED G
Date: 5/17/16 Permit Number: �GdS�Ua 1b
R E C E I'.' _D MAY 17 2016
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:.(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 250 Shinn Road Ft Pierce, FL 34945
Legal Description: 07 35 39 From Int of C/L of Orange Ac and W Li of SE 1/4 Run E Alg C/L 108 Ft,Th S 493 Ft to POB,TH E 208.71
Ft,Th S 208.71 Ft,Th W 208.71 Ft,Th N 208.71 FTTO POB(1.00 AC) (OR 3620-1279)
Property Tax ID#: 2307-422-0001-000-1 Lot No.
Site Plan Name: Picklesimer Residence Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove shingle roof and replace with new shingles
4/12 S �
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy:
HVAC 11 Gas Tank OGas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers 0 Generator W1 Roof
Total Sq. Ft of Construction: 576 S . Ft. of First Floor: 576
Cost of Construction:$ 16000 UtilitiesInSewer ElSeptic Building Height: 8 Ft
OWNER/LESSEE: CONTRACTOR:
Name Gary&Janet Picklesimer Name: Jamie Cisco
Address:250 Shinn Road Company: Sunshine Roofing, LLC
City: Ft Pierce State:Fl Address: PO Box 1083
Zip Code: 34945 Fax: City: Palm City State:FI
Phone No.863-581-9075 Zip Code: 34991 Fax:
E-Mail: Phone No. 772-260-8195
Fill in fee simple Title Holder on next page(if different E-Mail: sunshineroofingllc@gmail.com
from the Owner listed above) State or County License: CCC1327796
If value of construction is$2500 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 BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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
commencing work or recording our Notice of Commencemen .
Signatuf Owner/ nt/Lessee Signatur of Contra /License Holder
STATE t FLO l , STATE OF FLO I A 1 -
COUNTY OF �� COUNTY OF (��
The f r ging instr nt was acknowled a efore me The for ing instrum t was acknowledg d before me
this ay of 20 1 by this day of .20 by
1
Jamie Cisco
(Name of person acknowledging) (Name of person acknowledging)
Ai
( nature of Vtotary P -St to of f1bricla) ( ' ature of 46tary Public-State of lorida)
Personally Known t- OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produ 1una of Identification Produ
Woo �gNll
,% "�'''% �I ALYSS HAMPTON
ry Public-State of FI n�� ;�►�� ALYSS HAMPTON
190
Commission No. FF18 •.ro SPail mission No. FF1199o8 :•r° ¢'s( IJ public State of Flori
a
Commission N FF 1199)8 Commi/fifon#FF 119908
P;• NA.comm.Ewres Jul 18,2011
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS