HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �I _ Permit Number:
AQ
RECEIVED
Building Permit Application OCT 15 2019
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucle Countv
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
PROPOSED IMPROVEMENT LOCATIO-N - "t s
e
Address:
Legal Description: rnclicyl / ly—t. US c4507
Property Tax ID #: J"T o2- (ig o p- y� "' O l� Lot No. y�
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
of Lx;3}l�nS rev Cnc� inS�6I Y3t''.�
Gaernk-b AingkJ
d
CONSTRUCTION INFORMATION ;y
Additional work to je ne orme under this permit - c ec a apply:
0HVAC I _J Gas Tank Gas Piping In _ Shutters a Windows/Doors
11 Electric 0 Plumbing Sprinklers I Generator ® Roof Roof pitch
Total Sq. Ft of Construction: OSl a S . Ft. of First Floor:
Cost of Construction: $ cj , 0 06 Utilities:nSewer Septic Building Height:
OWNER/LESSE'E .
ON
Name -
Name: !l,a 4 /J-G
Company: TREASURE COAST ROOFING
Addresf.�C b
City: b r L� 1 Q,ry`' State: FG
Address: 1816 SW BILTMORE STREET
City: S/ State: FL
Zip Code: Fax: 772-343-8358
Zip Code:,3 y S Fax:
Phone No. 56 7 ?
E-Mail:
Phone No. 772-370-9770
E-Mail: TCROOFINGLLC@GMAIL.COM
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License: CCC1330653
it value of construction is $Z500 or more, a RECORDED Notice of Commencement is required.
N
SUP PLE`MENTAL.CONSTRUCT ON 6''EN';LA1N
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: 1816 SW BILTMORE STREET
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 attorne a ore
commencing work or recording your Notice of Commencement. _
1- / 1 // -1 1�
er/ Less/e/Contr#f)br as Agent for Owner I Signature of ContractO/Licerpg Holder
STATE OF FLORIDA v ICOUNTY
STATE OF FLORIDA
COUNTY OFST LCUIE OF ST LUCIE
The forgo! ng,instrument was, acknowledged before me
this Z day of07
20 by
BRIAN J MALONEY
Name of person making statement
Personally Known x OR Produced_ Identification
Type of Identification
Produced
La
(Signature of Notary Public- StO6 of Florida )
Commission No. 77�/a� (Seal)
Notary Public State of Florida
victor G Alterizio_
The for oing instrument w acknowledged before me
this T day of 20[I. by
BRIAN J MALONEY
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Produced
h
(Signature of Notary Public- Stat of Florida )
*ommission No. ,02%Z (Seal)
Public State of Florida
���r — o Victor
xpire. 11l0512022 = o ssio GG 274292
REVIEWS FRONT NCi NS VEGETATI sA i1o51 =ANGROV
COLINTER O' i `ram REVIEW REVIEW REVIEW ° REVl
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17