HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ��� �' `� Permit Number: n in
I J - RECEIVED
NINO Building Permit Application DEC 0 5 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,FortPierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof
-'PROPOSED IM'PROVEMENT'LOCATION -
Address: S( 3V I Ce. Rea(
Legal Description: �) U kal Dar,4LoC -qJC
L usf s 'S 1p- sn ok
Property Tax ID#:1� � - �l goo Q00"0 _ Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be Dertormed under this permit-check all appy:
1JHVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers OGenerator ®Roof S /oZ Roof pitch
Total Sq. Ft of Construction: OSGSS Sq. Ft.of First Floor:
Cost of Construction:$ ��'S'00 Utilities:RSewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Namev i Name:
Address: I a 1Oq- St. N Company: TREASURE COAST ROOFING
City: 1�-`% caval State:_5t Address: 1816'SW BILTMORE STREET
Zip Code: 33 15 Fax: City: State:FL
Phone No. '72;2- 3ag- "'M;- 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,&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:1616 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.
Si atu a of Owner/ !>Ae/C2�fz&or as Agent for Owner Signature of Contracti&WCenseii
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LCuiE COUNTY OF STLuciE
The for oing instirurpent was acknowledged before me The f r oing instru ent was acknowledged before me
this day of 2014 by this day of 26AV 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 Identification Type of Identification
Produced Produced
Z�A 6a -'r-4 W—cl�
(Signature of Notary Public-I qState f lorida) (Signature of Notary
Public-State of Flor' )
Commission NoL7G o27�19��'! ion /7/7
Commission 2��t 27 (Seal)
#7#'y*. otary Public state of loridaictor G Alterizioy Commission GG 2 4292
-*ovFNdF Expires 11 1=202.2
Victor GAlterizio;;;,,;,
REVIEWS FRONT Z VEGETATION 11 TW Co I ?.
COUNTER REVIEW REVIEW REVIEW REVIEW r�pp/�g$����QQ
Expire i11II5120
DATE KttVV
RECEIVED
DATE
COMPLETED
Rev.8/2/17