HomeMy WebLinkAboutBuilding Permit Application i
i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 2 2
Date: Permit Number: 110 41
i
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: 741 Nettles Blvd. Jensen Beach 34957
Legal Description: Nettles Island Inc,A Condo-Section II Parcel 741 and Pro-Rata Share in Common Elements(OR 270-659; 1331-1350)
Property Tax ID#: 4502-501-0927-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Sidi:
DETAILED DESCRIPTION OF WORK: {
i
Remove Shingles roof and replace with 5-V crimp metal
I
CONSTRUCTION INFORMATION:
Additional work to be nertormed under tispermit—check all appy:
HVAC _Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers ❑Generator) W1 Roof
Total Sq. Ft of Construction: 795 S . Ft.of First Floor: ��5r
Cost of Construction:$ 6500 Utilities: _Sewer❑_Septic Building Height: $
I
OWNER/LESSEE: CONTRACTOR:
Name Robert&Ruth Withers Name: Jamie Cisco
Address:741 Nettles Blvd. Company: Sunshine Roofing, LLC
City: Jensen Beach State:_ Address: PO Boz 1083
Zip Code: 34957 Fax: City: Palm City State:FL
Phone No.772-229-1414 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: CM 327796
i
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I
i
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: (hone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
i
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 elture of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF Ir 4 j n
The forgoing instrument was acknowledged before me The forgoing instrumeht was acknowledged before me
this )SL day of J&nycLr1 , 20 17 by this day of cirig!± 20_M by
" o erk I AT l�necS Jamie Cisco
(Name of person acknowledging) (Name of person acknowledging)
(Signat re of Nof)ary\RubIicJ State of Florida) (Signature of N tPub ic-State olf Florida)
Personally Kno n ° Q p �Ar4Wtio X Personally Known X OR Produced Identification
Type of Identifi t,$ upl figF' el Type of Iden=�E;P�re'
My Commission FF 230179 tate of Florida
�flExpires 06/28/201 elCommission No aCommissionn FF 230�7S�al)019
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COM PLETE
INITIALS
r