HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:�'W46 :3�`a1� Permit Number: `(�Zo s`(3U 1
RECER'�D M X.1 2 3 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: Roofs"`,� ` e
PROPOSED IMPROVEMENT LOCATION:
Address: 10701 S Ocean Drive#821 Jensen Beach, FL 34957
Legal Description: Venture Out at Indian River Inc Lot 821 (.OR 1170-708)
Property Tax ID#: 4511-510-0022-000-7 Lot No.821
Site Plan Name: Larocca Residence Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove shingle roof and replace with new shingles
CONSTRUCTION INFORMATION:
Additional work toe nertormed under t is permit—check a appy:
HVAC Gas Tank 0Gas Piping _Shutters Windows/Doors
11 Electric 1:1 Plumbing Sprinklers M Generator Roof
Total Sq. Ft of Construction: 646 SFt. of First Floor: 646
Cost of Construction:$ 3500 Utilities: Sewer 0 Septic Building Height: 8 Ft
OWNER/LESSEE: CONTRACTOR:
Name Theresa&Gus Larocca Name: Jamie Cisco
Address:6497 Casabella Lane Company: Sunshine Roofing, LLC
City: Boca Raton State:Fl Address: PO Box 1083
Zip Code: 33433 Fax: City: Palm City State:Fl
Phone No.954-401-1347 Zip Code: 34991 Fax:
E-Mail: Phone No. 772-260-8195
Fill in fee simple Title Holder on next page(if different E-Mail: sunshineroofinglic@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 BOLDER: _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 Commenc ent.
o�_ 9 � �
Signature of Owner/Agent/Lessee Signa q
e of Cont c License Holder
STATE OF FLORIDA STATE OF FLOR �
COUNTY OF COUNTY OF MOLY \ 1/\_
The forgoing instru ent was acknowledged before me The forgoing instru ent was acknowledged before me
thi day of 20_*by this-ay of 204 by
Jamie Cisco
(Name of person acknowledging) (Name of person acknowledging)
(S ature ofotary Pub c-State o natu
lorida) ( ' re Notary P 0--State Florida)
Personally Known OR Produced Identification X Personally Known X OR Produced Identification
Type of Identification Produc d i nse — – Tip of Identification Prod ced
w1107 t11111881" 9�__
Commission No. FFr�{$ �`��'�`� Seal) A[LYSS HAfi1PTON Co fission No. FF119908 ;`o}""�P�e; (Sea�l)`YSS HAMPTON
Ntlnry Public-State of F orlda Notary Public-State of Florida
Comml�slon#r FF 119908 Commission
�'%,,'11167V My Comm. spires Jul 18,2018 <;,• ",- my('omm Expires Jul 18,2018
Revised 07/15/2014 -�- .,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
COMPLETE
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