HomeMy WebLinkAboutBuilding Permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ` �.J' Permit Number:
• ,o ✓q� FIGQ
Building Permit Applicatiorf`�Gc�9o� �010
Planning and Development Services 0 0
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 t
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEM ENT LOCATION:
Address:1591 �r-
Legal Description: V ke i)AC u nil 5
Property Tax ID#: 34i Q _ Sq6— O�'"7 Lot No. 1�
355
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additionalworkto be nertormed under this permit—check all appy:
HVAC Gas Tank ❑Gas PipingMGenerator
Shutters Q Windows/Doo s
11 Electric E] PlumbingSprinklers r �Roof S Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$�� S` Utilities:n Sewer F Septic Building Height:
OWNERAESSEE: " CONTRACTOR:
Name 0r.,4 Name: //1?Zi4
Address: /G" Company: TREASURE COAST ROOFING
G
City: Q�i�� ue";e_ WV5 State:_G Address: 1816 SW BILTMORE STREET
Zip Code: 3 9U3 Fax: City:R0_2 _ V State:FL
Phone No. 71,7—,?-3799 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 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:t616SWBILTMORESTREET 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.
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.
Sign of Ow /Le /Contractor as Agent for Owner Signature of Contra4r/Lice�<Aolder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLcuIE COUNTY OF STLugE
The forgoing instrument was acknowledged before me Thefor oing instrument was acknowledged before me
this 147 day of �/�r.� 20;26 by this 7r day of 3�� ,20v2I 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
4�a- /_� e�z) � Z'a " aa1'1"7c::)—
(Signature
of Notary Public-Stat f Florida) Signature of Notary Public-State o lorida)
Commission No.� v27 a21f1 (Seal) Commission No. (Seal)
Nota Public State of FIwd
? Victo Alterizio n Notary Public tate of on a
REVIEWS FRONTGMyc `r �3hIS�` 9 P NS VEGETATI =� f„ Alte i�iq ,,�V
Expir s rhFiissi n WA5
COUNTER I IEW REVIEW T •ao�E Ws 11106 02:REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17