Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: S - RECEIVED • uilding Permit Application AUGA0 8 1017 Planning and Development Services Permitting Departmen, Building and Code Regulation Division St. Lucie Count: 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: POJ K CA Legal Description: i n k GJ S[:✓Gi r)n a OU 6 Property Tax ID#: 39 95 -70- '0 0U1 " 0CM Lot No. /o1 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: e.x;541.05 i-60-C Ctkq(c Ins. cdl Y-vtw CONSTRUCTION INFORMATION: Additional work to be oerformed under this permit-check all appy: HVAC Gas Tank []Gas Piping Shutters ❑Windows/Doors 0 Electric ❑ Plumbing Sprinklers Generator © Roof Roof pitch Total Sq. Ft of Construction: 475% Sq.L.of First Floor: Cost of Construction: $ 7, 7 SV Utilities: Sewer E]Septic Building Height:OWNER/LESSEE: CONTRACTOR: Name Name: ;a n H a I an" Address: a'?Q4 Z'1 as/L C_,t . Company: TREASURE COAST ROOFING City:� 5 -0 Y� 1 , Cd C,,'e, State: F c- Address: 1816 SW BILTMORE STREET Zip Code: I_N!q1q 5a Fax: City: _ (�- o A 6A. Lus i t, State..FL Phone No. -7 7 - I 1 Zip Code: 34984 Fax: 772-343-8358 E-Mail: NT— 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: 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 o Owner/Less o ct as Agent for Owner Signature of ontrac or Li Hol r STATE OF FLORIDA STATE OF FLORIDA COUNTY OF STLCUIE COUNTY OF STLUCIE The f95oing instru ent was acknowled a before me The ffing instr ment w acknowledged before me this day of a `�-1 2t by thisday of 20Je by BRIAN J MALONEY BRIAN J MALONEY Name of person makin tatement Name of person king statement Personally Known X Pod ced Identification Personally Known X OR Produced Identification Type of Identification Type of Identificatio Produced Produced (Signature of Nota If Pu lic- tate of Florida) (Signature 011Ary Pu lic-State of Florida ) Commission No. FF122434 (Seal) Commission No. F R08ERTBRUNKE Ed - ROBERTBRjutFlondj :• ; ^e Notary Public-Stateoforida Notary Public-StaCommissiommisslor ••;� Y omm.ExpiresREVIEWS IresOR PLANS VEGE ' I 1rf N� "N ROVE CB NaionREVIEW REVIEW REV EW DATE RECEIVED DATE COMPLETED Rev.8/2/17