HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /J q o?- o 4 cOC�
Date: ' �l' / Permit Num
R" ECEIVED
Building Permit Applicatiop AUG 21 2019
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial
PERMIT APPLICATION FOR: Roof
PROPOSEDAM'PROVEMENTsLOCATION.
Address: kw,Gino Pr-4
Legal Description: 0L.1 3 5 319 ' E-a ft. ou l. W SLC L! And ki blc U z?.
Property Tax ID#: a3 J,-I- d-3 Od /-r N v 7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
--7)—e C3" a w 4-V -33 w
CONSTRUCTION ,INFORMATION:
Additional work toe e orme under t is permit-check a appy:
HVAC Ei Gas Tank ❑Gas PipingMGenerator
Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers ® Roof s /a Roof pitch
Total Sq. Ft of Construction: /ti'43 SFt.of First Floor:
Cost of Construction:$ �� /p0 Utilities:Sewer Septic Building Height:
�O1NN;ER/LESSEE: CONTRACTOR:
Name A, 1�nvk a i yo, Q 1,n44
Address: 1011:5" a ee C O te�' Company: TREASURE COAST ROOFING
City: 0 � iG/r2 State:dp'-'4 Address: 1816 SW BILTMORE STREET
Zip Code: Zy9elSe Fax: City: 'Jo mock State.FL
Phone No. .2d 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'LIfN 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 our Notice of Commencement.
Signatur f 0 Lessee/Co ractor as for Owner Sign r ntractor/Lice a Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LCUIE COUNTY OF ST LUCIE
The forgoing instrume t was acknowledged before me The forgoing instrument was acknowledged before me
this �' day of a20�by this�lQday of 20/A by
BRIAN J MALONEY BRIAN J MALONEY T
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
a,4 IT 444
(Signature of Notary Public-Stat of Florida) (Signature of Notary Public-Statellf Florida)
Commission No.1/0o� 902 0 A (S t ry Public State of Floric aCo mission No. a7�.Z�t �— (Seal)
? Victor G Alterizio
My Commission GG 27429 40•y# Notary Public State of Florida
Expires 11/05/2022 a° �hVictor G Atterizio
My Coma ission GG 274292
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION dr UfftElTs 1 /R ffiGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17