HomeMy WebLinkAboutBuilding Permit application 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 thepermit 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.
2, r '14�
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Sig tur of ner/Less /Contra as Agent for Owner Signa r of C tractor/Lic se Hold
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LCUIE COUNTY OF ST LUCIE
The forgoing instrument y4as acknowledge before me The forgoing instrument was acknowledged before me
this / day of 20 by this�day of �U 64 ,20 (4 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
(Signature of Notary Public-Ate of Florida) (Signature of Notary Public--/St a of Florida)
Commission No. ission No ?7' 12 (Seal)
aoa►�r0i� Notary Public State of Flori a
Victor G Alt erizio
c , Z My Commission GG 27429 otary Public State of Florida
LxP'res 2022 : Victor G enz o
REVIEWS FRONT dl fSl9� NS VEGETA E/ 5/20 ANGRO
COUNTER REVIEW REVIEW REVIEW REVIE
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date: Permit Number: 1 ��
U,� 1y RECEIV n
Building Permit Application JUL 0 3 2019
Planning and Development services
Building and Code Regulation Division ST. Lucie County, Permitting
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
PR0POCis D.IM`PROVEMENT,LOCATIO,N
Address: IQ i3 RdII S .W c.54-
Legal Description:-��l Q iM bQ.t"1 j Q,Y�S 1-:k L k �_ b4-:S b )a
Property Tax ID#: "�� LI a 0 0-rl "- Lot No.
Site Plan Name: Block No. =-
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION.,OFWiORK v
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✓ cjyL18.�-E X ctcJ 15 n64- -o r,io' Rc,l rv�e baQ
CONSI"RUCTION:INFORNCATiON
Additionalwork to be performed under this permit-check all appy:
❑HVAC Gas Tank. Gas Piping _Shutters ❑Windows/Doors
FlElectric 0 Plumbing Sprinklers F]Generator Lll� Roof Roof pitch
Total Sq. Ft of Construction: 7c�-9 S . Ft.of First Floor:
Cost of Construction:$ y 0 Utilities:nSewer 0Septic Building Height:
OWNER/LESSEE `; , ;"{CONTRACTOR ..
Name d'>i c nGi Name: i L-40 pq 10' )q9'q
Address: 17 9 O a W Q Company: TREASURE COAST ROOFING
City: • LUCState: Address: 1816 SW BILTMOFtE STREET
Zip C de:-Sq �F 1 Fax: City: S C iQ. State:FL
t'Q
Phone No. S d C/ /7 Zip Code: 34984 1 Fax: 772-343-8358
E-Mail: Phone No. 772-370-9770 1
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.
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