HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Building Permit Applica ion OCT 0pigI8
Planning and Development Services Permitting Department
Building and Code Regulation Division St. LUcie Cou tyFL
2300 Virginia Avenue,Fort Pierce FL 34982 ,
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
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PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATIO
Address. yet(5 1 SAn4e.L. C, V6.
Legal Description: s_3aaa- J)ar k Uvqil q
Property Tax ID#: 1,301 - G6 !9-- 005Z,6 -- aoo -g Lot No.
Site Plan Name: Block No. 19
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION. OF WORK:
6 4 QX 5-1 qjc5t't O' L r*1 J ins �cl n t,w
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FCQR�TRUCTION' INFORMATION:,
Additional work to be nerformed under this permit—check all apply,
E1HVAC E]GasTank F]Gas Piping Shutte' rs ❑
Windows/Doors
11 Electric 1:1 Plumbing OSprinklers Generator Roof s Roof pitch
Total Sq. Ft of Construction: 1W002 Sq. Ft.of First Floor:
Cost of Construction:$ 3, 560 Utilities:[— Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name k/ :7 4_/0,157"mv.< Soc,'&4 Name: "�i a,-) A!qr)eA
Address: kUlk� bl(�`Algnsl %_W4 Company: TREASURE COAST ROOFNG
city: 5. cx t ' . qc � State': QA Address:
1816 SW BILTMORE STREET
Zip Code: Fax: City: -Opv4 6f, Loie_ State.FL
Phone No. 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: CCC1 330653
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 se ntr r s Agent for Owner Signature of Contractor i n Hol r
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LCUE COUNTY OF STLUCIE
The for ing inst umerit as acknowledge efore me The fo�rgging instru ent w acknowled a efore me
this��day o 20_by this May of 20�by
BRIAN J MALONEY BRIAN J MALONEY
Name of person making statement Name of person making statement
Personally Known xOR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
Y //
(Signature of#111 FIMic-State of Florida) (Signature o a P lir-State of Florida)
Commission No. FF122434 (Seal) Commission No. FF122434 y� (SPMRTBRUNKE
Notary Public—State of Florida
'P� ROBERT BRUNKE Commission#GG 176972
- :,,= Notary Public—State of Florida V_'41,'My Comm.Expires May 12,2022
•, ` OTuh Naonat NoryAssn.
REVIEWS FRON ` � F e l � °�hm. n�d�ldn�rttl3ci i PLANS VEGETATION
COUNT �Fd REVIEW REVIEW REVIEW REVIEW
DATE _
RECEIVED
DATE
COMPLETED
Rev.8/2/17