HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INF`O/MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: !- � T'� /� Permit Number: Iq o 9,3 �-
19 R EC's"o E I V E
Building Permit Application JAN 14 2019
Planning and Development Services
Building and Code Regulation Division Permitting D e p a rtm e
2300 Virginia Avenue,Fort Pierce FL 34982 Lucie County, F
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resi e4ti
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENTLOCATION `
Address: �b 2� l�� t✓,c` _
Legal Description: c7 i " YNQ,
Property Tax ID#:_13 1 C0 a 4�9— (0 0-b ' S Lot No. C�T O
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 toe nertormed under this permit—check a appy:
C]HVAC OGasTank Gas Piping _Shutters ❑Windows/Doors
Electric 0 Plumbing Sprinklers Generator ® Roof Roof pitch
Total Sq. Ft of Construction: C)S a a S . Ft.of First Floor:
Cost of Construction:$ q4 a 00 Utilities:cn Sewer Septic Building Height:
OWNERAESSEE CONTRACTOR:
Name I r^ LName: '
Address: 5316 3 CQt O Arne, uy-- Company: TREASURE COAST ROOFING
City: State: PL Address: 1816 SW BILTMORE STREET
Zip Code: X1401 5 L Fax: City: w CI-2 State:FIL
Phone No. Sl�. 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 1 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.
4
Signature BT-Owned/Lessee/ ontracto s Agent for Owner Signature of Contractor/License older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLCUIE COUNTY OF STLUCIE
The for Ing instrument was acknowledged before me The forgoing instruMgnj was acknowledged before me
his
tday of �I rJ 20� by this,' day of it/ 20/f 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
1'4� 14 "Zd Janele�
(Signature of Notary Public-Statee Florida) (Signature of Notary Public-State of Pbfida}
Commission NoO-�oL 7W�_A_ (Seal) Commission No. (Seal)
4xv P4* Notary Public Stat of Plodda
211 victor 13 100-1
ssion G 27a2g2 af' Vict G Afterizio
REVIEWS FRONT ZO SIt3Y6tE$o 2 PLANS VEGETATION Xyl o •�p6�ldp�ngi�pOp� 2a
COUNTER REV °i` REVIEW Exp"es 11S'CW
DATE
RECEIVED
DATE
COMPLETED
Rev.8j2/17