HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �l
Date: `� Permit Number:
' 10 RECEII/ED
Building Permit Application APR 12 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie Count P€arftl�ttlfKJ
2300 Virginia Avenue,Fort Pierce FL 34982 Yt _-
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line 3k
PRO POSED]MPROVEMMEENT LOCATION
Address: O IrQ fNI i q L,
Legal Description: lNt e.-{'O N t, S
Property Tax ID#: 3a 15 — `V 1 Lot No.�_
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:. 71
O,r d1 q.J nje,.-I aLitnt'. -
CONSTRUCTION INFORMATION:
Additional work to be performed under tispermit—check all that appy:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof / Roof pitch
Total Sq. Ft of Construction: $3a"1 S . Ft.of First Floor:
Cost of Construction:$ �, Z�b Utilities:liSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name ) 2rre,se m_\.ar\ Name: 0.
Address: 10N(603 -1—f-ciY�C Q!1 I U Bg5e j,N, Company: TREASURE COAST ROOFING
City:moi- c�C 4 LV C_t, State: Address: 1816 SW BILTMORE STREET
Zip Code:7�H 5 Sl'l Fax: City: !DOf4 54. LyG,_ State:FL
Phone No.SOS `7qJ " 1a cl'7 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 LINEN LAWINFORMATION:
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 our Notice of Commencement.
Z13— - ,
Signature of OwnecLLe9see/@Ktractor as Agent for Owner Signature o ontractor/Lice a Hol
STATE OF FLORIDA STATE OF FLORI
COUNTY OF STLCUIE COUNTY OF srLuaE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this It day of 2011 by this /( day of 20L 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 HUA REDHEAD Produced
"""' JOSHUA REDHEAD
��;�
?r° �Notary Public-State of Florida ;o �P°a,
•= Commission#GG 311365 = :Notary Public-State of Florid
'.; °.' My Commission Expires ;�• Commission# GG 31136
'iii����� P
March 13, 20
o � My Commissio
(Signature of Notary P - Ignature of Notary Public
" arch 13, 2023
Commission No. CG 11145 (Seal) Commission No: aG 3//.16 (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17