HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
• a—` RECEIVED
Building Permit Application FEB 062019
Planning and Development Services
ent
Building and Code Regulation Division Permitting
county
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, �a
PROPOSEDIMPROVEMENT LOCATION:
Address: (00G r,W 1 0%_J S Awe-
Legal Description: J I ark
PropertyTaxlDM IC 1 — Lot No. 10
Site Plan Name: Block No. C9_
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION Of WORK:
Ie,a� �-� Q,J�.�S�-ic� roo-� a►�� �ns�-�Ll ✓mow 5�.;.�91e,s e�� vim,.-1
CONSTRUCTION INFORMATION:
Additional work to be pertormed under this permit—c ec a appy:
HVAC ; Gas Tank ❑Gas Piping Shutters Q Windows/Doors
Electric Plumbing Sprinklers Generator ®Roof Roof pitch
Total Sq. Ft of Construction: 3`t
Sq. Ft.of First Floor:
Cost of Construction:$ R 110 Utilities:o Sewer E]Septic Building Height:
01NN ER/LESSEE; CONTRACTOR:
Name u0_3C1R.fi a Name: ,C<n
Address: X00 ry W i Ul�l-J'5 AV Company: TREASURE COAST ROOFING
City: i or� 6- % LU D Q- State: rL Address: 1816 SW BILTMORE STREET
Zip Code:Zq 9 SQ Fax: City: :Do-r-+ 5 ' LvC,l e State:FL
Phone No. aaa14- 3 I Zip Coder 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 iEN 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,1 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/Lessee/ ontracto s Agent for Owner Signa r tractor/Lic se Ho
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLCUIE COUNTY OF STLUCIE
i
The forgoing instrument w s acknowledged before me The forgoing instrument was acknowledged before me
this,3 day,of 75 j&( 20A by this y6_day of '� ,20�6 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 Jlai _dxy
(Signature of Notta7ry Public-Stat of Florida) (Signature of Notary Public-State of orida)
Commission No.(?�o97 ,?f 2 (Seal) Commission No&& 2'1-2 (Seal)
lav Notary Public State of ride to of Florida
Ay Commission GG 4262 a4 Victor G Alteri io
REVIEWS FRONT >�kPEA�113Q3[�IR PLA VEGETA N,�, . AMDf94�1R'i1 51z Pff&O
COUNTER, FV49phX~ 0 REVIE or RE /
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17