HomeMy WebLinkAbout5710 hickory dr.ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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F .L C? R E D. Yl
Permit Number:
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 :(
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line J�e . ;�Oc, 'r
PROPOSED IMPROVEMENT LOCATION:
Address:
r.
Legal Description:
Property Tax lD #: ` cl<) d — (;Q9 — Z)gel6 Y COOO — d Lot No.
Site Plan Name: Block No. 95/
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
lee -r or G�cr-�`i✓�� dG a,.ti �° �� �e� gar,,. f �n/`�f �
CONSTRUCTION INFORMATION:
Additional workto a er orme under tis permit —checka appy:
I1HVAC Gas Tank E]Gas Piping _ Shutters Windows/Doors
11 Electric Plumbing Sprinklers Generator Roof ��� Roof pitch
Total Sq. Ft of Construction: ��}} 430 S(3 -
Ft. of First Floor:
Cost of Construction: $ 7/ 700 Utilities: Ft' of
L�JSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
/
Name �+� v� S L zh^1
Name: 5i; ?i__ /fi=t°
Address:- 7l0r G/E
Company: TREASURE COAST ROOFING
City: Jamar-" /fir "/rr!1 State: f6
Zip Code: Fax:
Phone No. a 7 Z2 — 642 -7 o9?9
Address: 1816 SUV BILTMORE STREET
City: Rall_ State: FL
Zip Coddee: 34984 Fax: 772-343-8358
Phone No. 772-370-9770
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: TCROOFINGLLC a@GMAIL.COM
State or County License: CCC1330653
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEM NTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER; N.
Name: -- Not Applicable
Address:
city:
Zip: Phone State:
FEE SIMPLE TITLE HOLDER:
Name: —Nat Applicable
Address: 1816 SwBILTMORE STREET
City:
Zip: Phone:
MORTGAGE COMPANY:
Name: Not Applicable
Address:
City:
Zip: -��phone: State.
BONDING COMPANY:
Name:
Address:
City:
,Not Applicable
LIP* -- Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 certify that no work or installation has commenced prior to the issuance of a permit.
w n conflict with any applicable Home Owners Assocl
LucieCounty makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is iatlan rules, bylaws or and covenants that may restrict or
prohibit such
structure. Please consult with your Home Owners Association and review your deed for an restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in allyY
respects, er
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendmentsp farm the work
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 rec !&Yqur Notice of Commencement.
Signature o Owner/ ssee/C tr etor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Sr L --',;l E
The forgoing instrument as acknowledged before me
this Iday of /g 20,.4Q by
BRIAN J MALONEY
Name of person making statement
Personally Known x OR Produced identification
Type of Identification
Produced
(Signature of Notary Public- to of Florida }
Commission No. % (Seal)
1/_
Notary
pub"; Slate o
V;c10s G pltenz- 27
REVIEWS FRONT f
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
Signatu a ontract r license r
STATE OF FLORIDA
COUNTY OFST LUCIE
The forgoing instrumen was acknowledged before me
this __V day of r R 20,.�a by
BRIAN J MALONEY
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
(Signa ure of !Votary Publi tate of Florida ]
a mission No. c-2 75�&4 So)- (Sea 1)
3
Of
JLANS VEGETATION SE r N to Public
f 1 ,C lic St8te
REVIEW REVIEW R t � gay ozz