HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2%2!16
CQEJ INTY
Permit Number:
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 Jac- 260E
PROPOSED IMPROVEMENT LOCATION:
Address: 632o Fl6Vd cJdl,n��n IZ� rf. pierce ,F 4 3'l�lN7
Legal Description: Zea -l- V
Property Tax ID#:23a l- 877-600-5--000 9 Lot No.
Site Plan Name: Block No.
Project Name: _
Setbacks Front
Back: Right Side:
Left Side:
I DETAILED DESCRIPTION OF WORK: I
7—ear Df� 5hir)11e5 aid Under(ayme,?-A.
_7ns4'all 6)7tnyle.5 aid onderlayme44.
Additional work to lae ertormed under this permit— check all that apply:
HVAC Gas Tank E]Gas Piping Shutters Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 2 7 yS Sq. Ft. of First Floor: 2 -7115 -
Cost of Construction: $ (f�4 Utilities: 0 Sewer OSeptic Building Height: 1
OWNERAESSEE:
CONTRACTOR:
Name Z-duJard .'
Name: BRIAN J MALONEY
Address: (033n20 Floyd ._tJAn �,9n A-)
Company. TREASURE COAST ROOFING
City: F toiere-e State: FL
zip Code: 219/? Fax: NIA
Phone No.
Address: 1816 SW BILTMORE
City: FORT ST LUCIE State: FL
Zip Code: 34984 Fax: 772-343-8358
Phone No. 772-370-9770
E -Mail: N/A
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: TCROOFINGLLC@GMAIL.COM
State or County License: CCC1330653
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable
Name:
Address:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zi p: 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 thepermit 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.
s
_ Sig ture e rildsee4ge6 Signatufle of Co ac %L° a Hol r
STATE OF FLORI tI G i STATE OF FLORIDA
COUNTY OF L� COUNTY OF
Thefor ing instr ent wa acknowledged before me
this �Tday of 2(l Eby
V" A
(Name of pers n Wging )
(Signaturo otary P blic- State of Florida,)
Personally nownOR Pradutei klentificatrop
Type of Identificati n Produced.'.
Commission No.
#FF 122434
Revised. 07/15/2014
The forgoing instr ent was acknowledged before me
this day of 20 A_� by
(Name of_p(F do ag,4y(o w I e d g 1 n g )
(Signa t t#
of IWtary Public- State of Florida )
Personally Known OR Produced-
Type
roduced Type of Identification rod ed
Commission No.{Seal) f -A
�f 1-434
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