HomeMy WebLinkAboutBuilding Permit Application cl
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: C- —-?-1.9 Permit Number: - ' (c7
AIIIIIIIIIcr—_. _ ` _ ---1 RECEIVED
COUNTY` ' f
F 'L Q -. I_ 13
- - =-, MAR 0 7 2018
mummompsommummimi Building Permit Application
Planninguant
and Development Services Permitting a CounDepartt y
P St.Lucie County
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof
-PROPOSED IMPROVEMENT LOCATION:=_ . -
Address: % '3 1,,)l.il-e, -DI k Liv.
Legal Description: Eq51 LS 19....Q. reg4 q.1- SGvan'o, c,tol
Property Tax ID#: '3'-(a`i v1®1- b DiI - 17.-0 - ( Lot No. 1
Site Plan Name: Block No. S
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OFWORK: '
Iedo►f t( e i51-i n9 roof a.rNcl inS�0A-1 r &.i �i,,,pr,L0 51,1-nc cry c rc(
UrC L,t cAv\zieLiv.
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit—check all - apply:
❑HVAC I1 Gas Tank nIGas Piping Shutters QWindows/Doors
_
El
Electric 0 Plumbing Fl Sprinklers 0 Generator ® Roof 5/i) Roof pitch
Total Sq. Ft of Construction: 0 Cc.6 C. S . Ft.of First Floor:
Cost of Construction:$ to 00 Utilities: I Sewer 0Septic Building Height:
OWNER/LESSEE: 1 CONTRACTOR:
Name iCv�e,('c) E lj0.in'E Lauri 4 Name: -;r)Gn 1`'laW (
Address: `7 ES 63 uMQ, i h 5 Liu• Company: TREASURE COAST ROOFING
City:pcc4 51 Lve_ State: FL Address: 1816 SW BILTMORE STREET
Zip Code: 34¶Sa- Fax: City:TO-C- 4 Z.)c l4z- State:FL
Phone No. a7Z$- 9O - oD39 Zip Code: 34984 Fax: 772-343-8358
E-Mail: 1 Phone No.
772-370-9770
Fill in fee simple Title Holder on next page(if different E-Mail: TCROOFINGLLC@GMAILCOM
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 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 your Notice of Commencement.
•
Signatur Owner/ Z/con gent for Owner Signatu of tractor/Licens Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF sr LOUIE COUNTY OF sr LUCIE
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 Identification Type of Identification
Produced Produced
aiLazi
(Signature of Notary Public-S ,'to of Florida) (Signature of Notary Pu lic-Sta of Florida)
Commission No.Oy oaZY/ca f:2. (Seal) Commission No �o2 / / -9'2 (Seal)
X11 r Notary Public State.f Florida
Victor G Alterizio v+'t Notary Public State of Florida
My Commission GP 274292 l yyi��for G AI rizi
REVIEWS FRONT ZO a• S PERMSERV22 PLANS VEGETATION ' � comm �lt2
COUNTER RE • - , • • r 1 REVIEW % xpires 11/0MFEw
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17