HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q 0 0 oZ4 ,
Date: �' 3- 1-W-31D Permit b� ���
V �
JAN 3 2020
Building Permit Applica ion
Planning and Development Services Permitting Department,
Building and Code Regulation Division SL`. Lucie County, FL
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
vPROPOSED`I'MPF=EMENT_LOCATION:
Address: �?093a fronds Cv4 tjw
Legal Description:.& 3] FAZWf r-
i , er R.! Sec /dun S. s34 SS" d0 V �/ G✓of
.��c 760.37 F/ to Avw& .Pd. el, Dtr C ad 0?r Ad.
Property Tax ID#: Nol2 I- a 1 3 - a o/(- 000- S Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
FDETAILED DESCRIPTION OFF WORK: /
/rear af' ,1r/Gi f root LIa d ns�1 r Lewc4e, /6 o,4.,
'CONSTRUCTION INFORMATION:
Additional work toe pertormed under tis permit-check all appy:
HVAC Gas Tank Gas Piping _Shutters (�Windows Doors
❑ g I�Windows/
Doors
0 Plumbing Sprinklers ❑Generator a Roof S l Roof pitch
Total Sq. Ft of Construction: 5*31o?- S . Ft.of First Floor:
Cost of Construction:$ i l�,� d6� Utilities: Sewer F]Septic Building Height:
I�
OWNER/LESSEE: CONTRACTOR:
Name Name: rhe .0
Address: ago OF a. Company: TREASURE COAST ROOFING
City: o _r/ i; State: foG Address: 1816 SW BILTMORE STREET
Zip Code: 3VV87 Fax: City:4Od S- 441iC- State:FLI
Phone No. ?� . .370- X-CIA q Zip Code: 34984 Fax: 772-343-8358 'I
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.
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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 SWBILTMORE 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.
Signature of Owner/Lessee ntractor Agen wner Signatfi4&df Contractor 'cense r
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLCUIE COUNTY OF STLUCIE
The forgoing instrumen was acknowledged before me The forgoing instru ent was acknowledged before me
this 9 day of 25-;Q by this _-7 day of a/.lt/ 20ZO 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 Nota lic- Nota) P�b�I�Stare°f F1of 100 ignature of Nota yPublic
-State P�by,�grate of F°
C n ° 9: tt0lf Gfi189i0f1ZG0'274292 Notary ItenYG
4292
Commission No. M ��}nm
C mission No. 'ts{0i� In G Ssi°nooy7
It @41110512022 �� � ��10512022
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17