HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i
Date: r Permit Number: l NO-7 C
• RECEIVED
Building Permit Application OCT:012019
Planning and Development Services
Building and Code Regulation Division permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 St. Ducie C,unty
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
"PROROSEDIMPROVEMENT LOCATION:
Address: (0 602 A 1110;
Legal Description:
o-- 6-OD19
Property Tax ID#: I ?,d 8 DAi -- O-0CS— I Lot No.-1
Site Plan Name: Block No. �
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WOR k:
d e [Sr SiV �al
[CONSTRUCTION INFORMATION:
Additional work toe nertormed under this permit—check a appy:
E1HVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors
Electric ElPlumbingSprinklers E Generator Roof 5 :7: Roof pitch
Total Sq. Ft of Construction: oz V416 S . Ft.of First Floor:
Cost of Construction:$ 7j 596 Utilities:nSewer Septic Building Height:
OWNER/LESS.EE:. CONTRACTOR;
Name f \ • 1C k 1��Q.I-Le Name: I"I Q 61'1
Address: Company: TREASURE COAST ROOFING
City: 50A 3� ��+ State: `( Address: 1816 SW�BILTMORE STREET
Zip Code:�!>Clq 5 �Faax: City:��a / .xs. •_ State:FL
Phone No. 9o9.1- 7 9 0 v SY04 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.
I
SUPPLEMENTAL CONSTRUCTION LIEN LAW IRfOR`MATION
DESIGNER/ NGINEER: Not Applicable MORTGAGEE 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 prohlbitlsuch
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.
Sin a of OwneL/X4ssee/ ractor as Agent for Owner Sign Contracto icense of r
STATE OF FLORIDA STATE OF'FLORIDA
COUNTY OF STLCUIE COUNTY OF STLUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 27 day of Serol. ,20 I by this ?>day of 5a�. ,20J� 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
Ignature of Notary Public-State of Florida) (Si atu a of Notary Public-State of Florida)
Commission No. Crjr 3//365 (Seal) Commission No.:G .$//36S (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/.17 �ti`P'�'r'v�B.; JOSHUA REDHEAD `o1`�'ra�eJOSHUA R:DHEAD
Bio c"=Notary Public-State of Florida a: ,Notary Public-SFlorida►= Commission#GG 311365 y := Commission# 11365MylCommission Expires '�; o�°.' M CommisspiresMarch 13, 2023 '���" y March 13 ,
I
�. I