HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCE0-0 bi—OR
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Building Permit Applic Vigo;
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Planning and Development Services
(411 tYFL
Building and Code Regulation Division ,
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential OZ
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
TROPOSEWI 'P'kOVEMEN-r'LOCATION , -'-- '!- ','--"'
Address: ralo 9 -I_A_n!3e,1b _bQ_
Legal Description: �?1AiQz) �RAug-'r Q444s un-A 09
Property Tax ID#: 3y0a oqos - 00 0- _C, Lot No.
Site Plan Name: Block No'%
Project Name:
Setbacks Front Back: Right Side: Left Side:
'DETAILED DESCRIPTION OF WORK:
reave of yo4i r-b u eZ,+g
CONSTRUCTION INFORMATION:
Additional work tobEi
rformed under this permit-check all that apply:
F]
HVAC GasTank 0Gas Piping _
E]Windows/Doors
Electric E] Plumbing OSprinklers Elenerator 0-Roof Roof pitch
Total Sq. Ft of Construction: .7 ySv6 Sq. Ft. of First Floor:
Cost of Construction:$ Utilities:r ]SewerOSeptic Building Height:
OWNERAESSEE: CONTRACTOR:
Name i Name: Z4 Wo.,e e,rl
Address: 1,'33 SA-r jge�c,- Company: TREASURE COAST Ro6FING
City: 5/ z/1'..".1 State:_jt-:'o4 Address: 1816 SW BILTMORE STREET
Zip 1?ode:..,?ff Fax: -
City:,4Wjz ,,6,c1e State.FL
Phone No. 72.2-,3 76y ACl%2.K 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: CCC1 330653
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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 permitto do the work and installation as indicated.
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.
7'_Z11 -1 1 -e- , I.
Signature o ner/Lesse Co for as Agent for Owner Signa a of Contr or/ ' nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LCUIE COUNTY OF STLUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ag day of 20-?-0 by this day of 20_ 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
Typeof Iden 'fication Type of Identification
Produced Produced
�lre�_ 412
(Signature of Nota c-State of Florida) (Si nature of Nota P Ic-State of Florida
Commission No. 7 y,192 (Seal) Commission No. teotpwtlda
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of Florida NotaN G pttenxGG 2429
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REVIEWS FRUM-PEii#W
`ZO�IDlGJJJo "ZP PLANS VEGETATION S r AE NGROVE
COMEWREVIEW REVIEW V REVIEW
DATE °f
RECEIVED
DATE
COMPLETED
Rev.8/2/17