HomeMy WebLinkAboutBUILDING PERMIT APPLICATION i
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 u
Phone: (772)462-1553 Fax: (772)462-1578 Commercial I Residential X
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PERMIT APPLICATION FOR: Roof
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PROPOSED IMPROVEMENT LOCATION: s
Address: 417 W.Weatherbee Rd. Ft. Pierce, FL 34980 j
Legal Description: White City SID 03 36 40 from NW comer of Lot 5 run S 20 ft.for POB,th run E 95 ft.th W195 ft.th N tojPOB(0.75 ac)(Map 34/03N)(OR 1290-807)
Property Tax ID#: 3403-502-0011-000-7 i
Lot No.
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Site Plan Name: Block No.
Project Name: I
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION OF WORK: IIS 2
Remove shingles and replace with new shingles on the back shed
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[CO=�STRU:CTIO' N-INFORMATION: '
Additional work to e e orme under this permit—,heck ec a appy: d
E1HVAC E]Gas Tank Gas Piping _Shutters ! Windows/Doors
❑ ❑
F]Electric ❑ Plumbing Sprinklers Generators Roof
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Total Sq. Ft of Construction: 480 S . Ft.of First Floor:
3500 I
Cost of Construction:$ Utilities: _Sewer O i eptic � Building Height:
OWNER/LESSEE: CONTRACTOR: ;I 4
Name Mike Laiben(Easy Livin RV Park Name: Jamie Cisco e
Address:4611 S US Highway 1 Company: Sunshine Roofng, LLC
City: Ft. Pierce State:_ Address: PO Box 1083
Zip Code: 34982 Fax: City: Palm City j q' State:FL
Phone No.772-215-0749 Zip Code: 349911 + Fax:
E-Mail:mcllbn@yahoo.com Phone No. 772-260-81951;
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
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If value of construction is$2500 or more,a RECORDED Notice of Commencement isiequired. l0
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION. j
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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:
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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,injall 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 an ther non-residential use
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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
coqimencing work or recording our Notice of Commencement. 117
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Signature of Owner/Agent/Lessee Signature of ntractor/License Holder
STATE OF FLORIDA STATE O FLORIDA
COUNTY OF SL Lucie COUNTY OF Martin
The forgoing instr�Wt was acknowledged before me The forging instrument was acknowledged before me
this e� day of i an t-ir`y 20 17 by thisQ,5 day of �Z n want' 20_j7 by
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Mike Laiben Jamie Cisco
(Name of person acknowledging) (Name of person acknowledging)
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(Signa re of Nckary Pub c-State df Florida) (Signa ure of N tart'Pu ic-Stat of Florida)
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Personally Known OR Produced Identification X Personally Known X;
OR Produced Identification
Type of Identificatio a Type of Identification Produced
Notary Public State of Fbrida
Commission No. +� erUynKidipl) ' Commission o. fyPut�iicStateOf I
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ander My Commission
ires FF 230179 Madlyn Kluegel
My Commission FF 230179
opp Expires 06128/2019
Revised 07/15/2014 I
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION, SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
CO M P LETE
INITIALS
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