HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I J� /�
Date: i'//g//gPermit Number: \�V ` -l) 4-1
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=RECEIVEDBuilding Permit ApplicationPlanning 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: 12-15 SE .5E/2Enl1J7-A 00og7 AET 5T Z V e , Fe-
3yjS2
Legal Description: 12-=v,-- i2 t0h 2K UN s r S /3/1<- 96, L o T 22-
Property
2-
Property Tax ID #: .3 `I'7- 6-'10 - 012-6- Opo -3 Lot No. 22
Site Plan Name: Block No. y6
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
-7—C,4/7- OFF CXs5TING /GOOF. In/S 7-,9LL A4/ W 614.zN6!L63 4/J0 l/IVOEeLAYME
4Glt L4
[CONSTRUCTION INFORMATION:
Additional work to be oertormed under t ispermit-check all that appy:
HVAC Gas Tank Gas Piping 1:1Shutters Windows/Doors
❑Electric ❑ Plumbing Sprinklers 1:1 Generator Fv-(] Roof
Total Sq. Ft of Construction: / SYG Sq. Ft. of First Floor: /.j V(-
Cost of Construction: $ G,Oap Utilities: Ll Sewer F]Septic Building Height: 1
OWNER/LESSEE: CONTRACTOR:
Name_MAIZ-TA //4AlGEL0NE Name: BRIAN J MALONEY
Address: /2S SE oc,gT Company: TREASURE COAST ROOFING
City: POIZT 5T Lu,-,'F: State:FL Address: 1816 SW BILTMORE
Zip Code: 3 y$SZ Fax: N/A City: PORT ST LUCIE State:FL
Phone No. Zip Code: 34984 Fax: 772-343-8358
E-Mail:N/A Phone No. 772-370-9770
Fill in fee simple Title Holder on next page ( if different E-Mail: TCROOFINGLLC@GMAIL.COM
from the Owner listed above) 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 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 or rRcording your Notice of Commencement.
S
_Signature of Owne ee/Agent Signature of Contractor rise er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF:* 1, G COUNTY OF J'r Lcnc`_1C
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 22day of 4n 20 L.Zby this Zklay of 20 SV by
(Nam persona n edging) (Name of person owledging)
S! natur Nota Public-State of Florida
(Signature otaryP lic-State of Floridat)liilld8j, ( g ry �e+��111uiflyll��
r RTBA(j,I//
Personally Known OR Pro
cd`ci4.,- #I �rUl�n ��_ Personally Known OR Produces tler��! •.
Type of Identificatio Produced o� 12,2 rOi'•�% Type of Identification Produced y tie.? f
Commission No. �* (SeIl)- N •*r Commission No. 2*;(Seaq�•�
:•• #FF 122434 ;Q= z #FF 122434
o r =0�, •.
Revised 07/15/2014 V/";/voc %,, /0 STA_cE(3
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS I JI