HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 51�6��� Permit Number: VA 41E)- 13`Al
sRECEIVED
Building Permit Application mg 6 2�M$
Planning and Development Services
Building and Code Regulation Division 5-r Lucie counttrr ittin�
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: 'To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 174 SE SELVA CT
Legal Description: RIVER PARK UNIT 7
Property Tax ID#: 3419-550-003-000-6 Lot No. 7
Site Plan Name: Block No. 62
Project Name:
Setbacks Front Back: _Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
TEAR OFF EXISTING ROOF AND INSTALL NEW TAMKO SHINGLES AND UNDERLAYMENT
CONSTRUCTION INFORMATION:
Additional work to be nerformed under t ispermit—check all apply:
HVAC Gas Tank E]Gas Piping Shutters ❑Windows/Doors
Electric ❑ Plumbing ❑Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: zee 11 o a S . Ft. of First Floor:
Cost of Construction: $ 10,000 Utilities:Sewer []Septic Building Height: 5112
OWNER/LESSEE: CONTRACTOR:
Name DAVE WHITTEMORE Name: A Cr1 T mku-r
Address: 174 SE SELVA CT Company: TREASURE COAST ROOFING
City: PORT ST LUCIE State:FL Address: 1816 SW BILTMORE STREET
Zip Code: 34983 Fax: City: PORT ST LUCIE State: FL
Phone No. 971-0749 Zip Code: 34984 Fax: 772-343-8358
E-Mail: AJ 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: E Name:
Address: 1 Address: - --- -T
City: PGiaaaaw'E State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:l T 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.
Z- 'I —/1 2 'J
Signature of Owner/LesiWlCoq a or as Agent for Owner Signature of Contractor/ ' nse of r
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LOUIE COUNTY OF ST LUCIE
The forgoing instrument was acknowledged before me The forgp Ag instrument was,,acknowledged before me
thisday of 1N1 r'!Y 20]k by this ay of ✓i�lv�: 20A by
BRIAN J MALONEY BRIAN J MALONEY
Name of person making statement Name of person making statement
Personally Known x O Produced Identification Personally Known x Produced Identification
Type of Identificatio Type of Identification
Produced Produced
(Signature o�= 2 P - iawlioi (Signature of Public-S of Florida)
ROBERT BRUNKE
State of Florida :='tom •: ERT BRUNKE
Commission No. za I :. .• : Notary�9�I� Commission No. FF122asa : ° ,,CC
Com�issro�#GG 176972 e C. "= Nd�
M Comm.Expires May 12.2022 blio-State of Florida
y Commission#GG 176972
- cr`;`' Bonded through NaSona:Notary Assn
•,,".c�. 'My Comm.Expires May 12.2022
_"W 11131 tart' n.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGR
ROVIE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17