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Date: Permit Number: 1-i n 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: 10725 8 Ocean Or Lot 203 Jensen Beach,FL 34957
Legal Description:_Holiday Out at St Lucie BLK F LOT 19 and Equal Pro-Rata interestin Common Elements .
or(3810.1237;3816-2201)
Property Tax ID#: 4511.501-0192-000.1 Lot No_ 19
Site Plan Name: Block No. F
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION OF WORK: ;
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Tear off existing shingle roof and install 11 e=Co Icr&J h'! p lg'1 iroaNd
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CONSTRUCTION INFORMATION-
AdclitionalworKtotienertormed under
this permit—check a appy:
HVAC iping Shutters aWindows/Doors
_Gas c
Electric Plumbing OSprinklers OGenerator
ll"J Roof
Total Sq.Ft of Construction: J7 Sq.Ft.of First Floor:
Cost of Construction:$ (o,c�r�• ' Utilities:USewer Septic Building Height:
OWNER-AESSEE: CONTRACTOR:
Name C', y i sli6p)nC r R)L� h rv, Name: Ronald Latta
Address: I c�U 2.s- s C>C z P,;,A br, 4::l'-2-r)3 Company: Treasure Coast Concepts Inc
City: State:_lam- Address: 3458 SW Pluto St
Zip Code: :3 LI KS!✓ Fax: City: Port Saint Lucie, State:FL
Phone No.,2 q S- T7 Lf- �L4 t-1 Zip Code: 34953 Fax:772-905-4910
E-Mail: Phone No. 772-777-8130
Fill in fee simple Title Holder on next page(if different E-Mail tcconcepts @_aol.com
from the Owner listed above) State or County License: CCC1330362
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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 financhiL consult with lender or an attamey before
commencing work or recording your Notice of Comrneneernent.
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