HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t u
Date:\)i Permit Number:
HUMID NOV 10 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 ; ,,<4r X '
PROPOSED IMPROVEMENT LOCATION:
Address: 10851 S. Ocean Dr. #27, Jensen Beach FL 34957
Legal Description: Windmill Village By-the-Sea Condominium No 1 Unit 27 and Pro-Rata Share in Common Elements(OR 3680-840)
Property Tax ID#: 4511-810-0034-000-5 Lot No.
Site Plan Name: . Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove existing shingle roof, replace any damaged plywood, install metal roof.
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CONSTRUCTION INFORMATION:
Additional work to be nertormed under t ispermit—check a appy:
HVAC Gas Tank ❑Gas Piping MGenerator
Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers W1 Roof
Total Sq. Ft of Construction: 890 SF S . Ft.of First Floor: 890 SF
Cost of Construction:$ 6,000.00 UtilitiesliSewer 0Septic Building Height: 8'
OWNER/LESSEE: CONTRACTOR:
Name John&Linda Rollins Name: Jamie Cisco
Address: 10851 S. Ocean Dr. Lot 27 Company: Sunshine Roofing, LLC
City: Jensen Beach State:_ Address: PO Box 1083
Zip Code: 34957 Fax: City: Palm City State:FL
Phone No.772-237-5121 Zip Code: 34991 Fax:
E-Mail:Irollings55@outlook.com 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 Commencement.
Signature of Owner/Agent/Lessee SiZTE
a of Contractor/License Holder
STATE OF FLOR DA S OF FLORIDA
COUNTY OF I & Lio_'i e- COUNTY OF
The forgoing instrument was acknowledged before me The forgoing inst�r yment was acknowledged before me
this day of I�DVC�rn X r 20 Eby this2! day of 1 161/Cml2r— 20�by
L„1 � [j ( Jamie Cisco
(Name of person acknowledging) (Name of person acknowledging)
"-Mtl JADIZ/Y-) 4<OA$��
(Signat_re of Notar-Publi State of Florida) (Sign ure of N to Publi -State f Florida)
Personally Known v"' OR Produced Identification X Personally Known X OR Produced Identification
Type of Identificati P�9'ti Type of Identification P
rej%
Notary PU�blof Florida o'er Note PuCommission No. Marilyn CommissionNo. Marttyn�eof Florida My Commission FF230179 �i,� ` MY Commission FF 230179
ora ExplMs 08!28/2019 Or rt Expires 06/28/2019
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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