HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Nun Ber:
IVED
- Building Permit Application NOV 2 9 2018
Planning and Development services Permitting Department
Building and Code Regulation Division St. Lucie Count FL
2300 Virginia Avenue,Fort Pierce FL 34982 yr
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Kesidential -�
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line ,
PROPQSEDIAWV ROVEMENT,LOCATIO'N.i „_..
Address: 5a �n kl �aU
Legal Description: nC,,,,nJ22 ,K-4.5�c'��;a Qx-a�i tlP��1�t �u �f
Property Tax ID#: (�I - Jr� - Z)IqC?-(3c7(�3 -ft Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION PF'WORK:
5 a S� ti1�2w -Tp nm ca . f-o 0i M•c�,
EONSTRUCTION INF.ORIVIATION:
Additionalwork to be nertormed under tispermit-c ec ,a apply:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric ElPlumbing Sprinklers ElGenerator E] Roof S/a Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$�Tt�6 Utilities: Sewer E]Septic Building Height:
;OWNER/LESSEE CONTRACTOR: ,
Name ► �' Name: nLA
Address: r�l � Company: TREASURE COAST ROOFIffd
City: -_ �o� State: FL Address: 1816 SW BILTMORE STREET
Zip Code: '3�:J Of b4 CJ Fax: City: a I State:FL
Phone No. - 'K 15 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 Counter makes no representation that is granting a permit will authorize thepermit 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 FloridaBuilding 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.
Signatu of Owner/Les a/Cont for as Agent for Owner Signat re ontractor/Lic se Holde
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLCUIE COUNTY OF STLUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20_ by this day of 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 Identificatio Type of Identificatio
Produced a is nate of Florida Produced Iic State of Florida
Deborah J Caccietore fMxpires
h J Cacciatore
MY Commission GG 148734 mission GG 148734
ar Expires 10/11/2021or 1 0/1 112 0 2 1
(Signature of Nto ublic-State f Florida) (Signature of Notary Public-State of Eloricla)
Commission No. (Seal) Commission No. (Seal)
I4-13 Lks-1-5
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17