HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
•
Building Permit Application JUN 2 6 2018
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Jude County
2300 Virginia Avenue, Fort Pierce FL 34982 /
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential 1
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION: �I
Address: '2 17 -2r 1<1"h
y" t n l z Gb r .
Legal Description: Lij) ks CA� JCyc/is)C9 0��
Property Tax ID#:3<4,11S 7 O 7 Oa act a — S Lot No. �y
Site Plan Name: Block No. 3`f
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRI PTION OF WORK:
-- ?Q,a r O � e h i s t r n Jc c-o of 4(1 i e):S n� 7�i`1/►ti k-,,)
CONSTRUCTION INFORMATION:
Additional work to b rformed under this permit–c hecka apply:
HVAC Gas Tank []Gas Piping _Shutters Windows/Doors
Electric Plumbing Sprinklers [Generator Roof S /d Roof pitch
Total Sq. Ft of Construction: d'013/ S . Ft. of First Floor:
Cost of Construction: $ C4060 Utilities: El Sewer-Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name RAI, Jig A/_7 016 ",1_0�2y U S Name: 1\ ("006--"
Address: 76 HIAA /&/e ,Or• Company: TREASURE COAST ROOFING
City: Dor–A S�. G(/P"G State: G Address: 1816 SW BILTMORE STREET
Zip Code: Fax: City: State:FL
Phone No. 7 7— t 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/Lessee ntrac r s Agent for Owner Signature of Contractor/Lice se Hol r
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLCUIE COUNTY OF STLUCIE
The forgoing instrun=t was acknowledgedbefore me The fgjgoing instrttiAent was acknowledggd,pefore me
this��day of W�L ,20�?f by this ay of J ^� 20_ by
BRIAN J MALONEY BRIAN J MALONEY
Name of person making statement Name of perso making statement
Personally Known x O Produced Identification Personally Known x OR Produced Identification
Type of Identificatio77 Type of Identificat'
Produced Produced
77,W, k1l
(Signature of VL a J$-, tate of F�ds1BRIJNKE (Signatur tart'Public- i
r°. �`�� Notary Public-State of Florida ;,o�;�;o`.,, 4A
Commission No.
Commission O. FF12 b4 Commiy � G 176972 FF122434 d�� ��`: N ER78RUNKE
mycomm.
l'xpire May 12.2022
.° tic-State of Florida
Bonded:hro,rgn.Na:iona No:aryAssn = COmmisSiprt#GG 176972
°•'. °F;. MY Comm.Expires May 12 2022
Bonded h
a^,Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGR
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17