HomeMy WebLinkAboutPERMIT 1201 FLEETWOOD LNALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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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
PROPOSED IMPROVEMENT LOCATION:
Address: Ias i 'F/e"t,J U 0O8 ( a
Legal Description: r ocid 1q NO r — Sk,Q.4+
Property Tax ID #: 3q 0 7 — So� I �a b Lot No. Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
__Te_'CXV- <'3� ey l::Ai+ns r-Qizif aAd PAST all ntkw S' � 9lfl avL�l
/000re- Gs cl �i�Ir� if r�Gc✓ /-
CONSTRUCTION INFORMATION:
Additional work to b rtormed under this permit — c ec a11 apply:
LlHVAC Gas Tank Gas Piping _ Shutters a Windows/Doors
Electric Plumbing Sprinklers I Generator ® Roof Roof pitch
Total Sq. Ft of Construction: 9 O S . Ft. of First Floor:
Cost of Construction: $ / (2 Utilities: Sewer ESeptic Building Height:
OW N E RAESSEE:
CONTRACTOR:
Name
Name:
Address: r vo �L/,
Company: TREASURE COAST ROOFING
City: r4 State: FC
Zip Code: J y9 �a Fax:
Phone No._ . _ �S_2 - S/g i[
Address: 1816 SW BILTMORE STREET
City:-z 4��. State: FL
Zip Code: 34984 Fax: 772-343-8358
Phone No. 772-370-9770
E-Mail:
Fill in fee simple Title Bolder on next page (if different
from the Owner listed above)
E-Mail: TCROOFINGLLC@GMAIL.COM
State or County License: CCC1330653
it value or consirucrion is lLSUU or more, a RtCURDED Notice Ot Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name:_
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address: 1816 SW BILTMORE STREET
Citv:
Zip: - Phone: —
State:
— Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
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 vour Notice of Commencement.
Signature of Owner/ sse ntractor as Agent for Owner
Signaturf of tractor/L'c,p4se Hol
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST LWIE
COUNTY OF ST LUCIE
The far ing instrument was acknowledged before me
/day
The forgoing instrument was acknowledged before me
this day of z0 by
this of 2Q,jby
_1 L
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
Z A6��
Produced
Z jz�(�
(Signature of Nota/ry/Public-,St/.at of Florida }
{Signature of Notary Public- State o Florida )
Commission No.L](y �%I�`�� (Seal)
Commission No.(S (Seat}
Notary Pudic State of Flonci
REVIEWS
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COUNTER
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REVIEW
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DATE
RECEIVED
DATE
7-7
COMPLETED
Rev. 8/2/17