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HomeMy WebLinkAboutBuilding Permit Application i ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �, A(� Date: Permit Number:% l.� ZUO l - U tom Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce.FL 34982 Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential `x PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line OROPOSED`IM PROVE MENT'LOCATION: Address: G.<is fb 10. V Legal Description: - LcQ kQ.w o o A 5�R.f k unit .5 _Lx 5 a Lfi4 a a an ) at(o Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: SIrtbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: ��ar p `� o,�.i�'C�C�oJ rob Gr+� I�r1S� alb n� Sh,{.n Cztic✓ i-CONSTRUCT,10'N'INFOR'MATION: Additional workto e e orme under this permit—check a apply: �HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doo s 11 Electric 0 Plumbing Sprinklers E Generator © Roof Roof pitch Total Sq. Ft of Construction: bgau S Ft.of First Floor: Cost of Construction:$ Az xda Utilities:0 Sewer Septic Building Height: I OWNER/LESSEE CONTRACTOR: Name ih 1 Name: /Gt✓' tit - Address: 7 oL Company: TREASURE COAST ROOFING City: Q %lC? State: t9 Address: 1816 SW BILTMMORE STREET Zip Code: o t?fJ 7 Fax: City: 49O/1l S LI/U�i State:FL Phone No. 7?�- C'o7" 3 6 99 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: Ad d ress: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 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 Noticelof Commencement. Signature of 6vVnherl Lessee" ontr or as Agent for Owner Signal ar Contractor/ cens older (STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ST LCUIE COUNTY OF STLUCIE The for'going instrument was acknowledged before me The forgoing instrument was acknowledged before me this day'of� ,�y ,2Q,7� by this 9 day of BAN 20g?S?by BRIAN J MALONEY BRIAN J MALONEY i 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 G'f �Z�a�Z Produced G'7ts ?y�z G (Signature of Notary Pu Ic-State of Florida (Si nature of Notary P -State of Florida) Commission No. �(Seal) d�o ission No. (Seal) GG 92 yr �, Notary Public Slate of Florida ° rizio y Comjp512 � : My Co mission GG 27429 REVIEWS FRONT t *Sl`3� PLANS VEGETATION R-�i�ves 1ROV COUNTER R I E W REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17