HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 \T, ,� Permit Number: 1��5JQd to
• RECEIVED
Building Permit Application MAY 01 2018
Planning and Development Services
Building and Code Regulation Division
'''rtYlittirl�
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential YES
PERMIT APPLICATION FOR: 'Roof
PROPOSED IMPROVEMENT LOCATION:
Address: ��`� C� G1I)
Legal Description: LOT 10 (OR 3017-1105
Property Tax ID 3L\9,4Z d3"' O�°�y add 0" 1 Lot No.10
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
SLIP SHEET AND INSTALL TAMKO HERITAGE SHINGLES
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all that appy:
HVAC Gas Tank F]Gas Piping Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof 6/12 Roof pitch
Total Sq. Ft of Construction: 2,695 SFt. of First Floor:
Cost of Construction: $ 9,600.00 Utilities:cnSewer OSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name:
Address: a5'_q9 Company: TREASURE COAST ROOONG
City: 4Z4 State:,"�'_/ Address:.1816 SW BILTMORE STREET
Zip Code: 61 qJ 2 Fax: City: _State: FL
Phone No. 7-7;2 - -'-�24 — 77 Zip Code: 34984 Fax: 772-343-8358
E-Mail: 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: 1816 Sw BILTMORE STREET Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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/L e/C tr or as Agent for Owner Signature of Contra License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LCUIE COUNTY OF ST LUCIE
ThejiWing instrMr )i
scknowledge efore me The�qr ing instru nt wa acknowledg efore me
this day of 201 by this LL day of H IV 20 by
BRIAN J MALONEY BRIAN J MALONEY
Name of person making statement Name of person making statement
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identificatio
Produced Produced
(Signature o o Pu State of Florida) (Signature ry Public-State of Florida)
Commissio 0. FF122434 Commission No. FF122434 (Sea FtO c"
BERT BRUNKE � .
RT
BRUhKc"
Notary Public-State of Florida %'is", 1 Natar.Public-Sfot=o•Flo d
Commission#GG'7697Z _ Gom;riss.cr GG 7697
F F, P.I-i ynrt.
60nded:hr hNanna N��zn.;;r^ -- - - 2
REVIEWS FRONT e PLANS VEGETATION SEA T ``•_ary sn.
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17