HomeMy WebLinkAboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Permit Number:
Building Permit Application
Planning and Development 5ervices
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: _Tiv r5 1 V
Legal Description: lC Ob d Gkf 1<
Property Tax ID #: J � W ' I - �i Lot No. i
Site Plan Name: Block No. r?
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
1-7
CONSTRUCTION INFORMATION:
Add
f�itiona wor to e e Orme under is 15:Fluee
aM I ppy:
L=fHVAC1:1Gas Tank Cas Piping
Shutters a Windows/Doors
Electric 1:1 Plumbing O Sprinklers
[ Generator Roof a Roof pitch
Total Sq. Ft of Construction: /�29
Sof First Floor:
Cost of Construction: $ '8900 Utilities:
Sewer D Septic Building Height:
OW N ERAESSEE:
CONTRACTOR:
Name L 91wt11
Name: �n i2 O✓ e4
Address: d 44 i ; vs A IJ4
Company: TREASURE COAST ROOFING
City: e rear State: `e
Address: 1816 SW BILTMORE STREET
Zip Code: _ .3K9511 Fax:
City: .f e State: FL
Phone No. ca 7--0 $ 9
Zip Code: 34984 Fax: 772-343-8358
E -Mail:
Phone No. 772-370-9770
Fill in fee simple Title Halder 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 $2540 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: 1816 SW BILTMORF 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 Notice of Commencement.
Signa f Own Lessee�ntrac`torasgent for Owner
STATE OF FLORIDA
COUNTY OF ST Lcuir
The forgoing instrument was acknowledged before me
this Ja day of ,"'I 20A by
BRJAN J MALONEY
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Produced
(Signature of Notary Puftate of Florida )
Commission NO. {�
State 01
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DATE
RECEIVED
DATE
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Rev. 8/2/17
Signat a tractor ' ense H r
STATE OF FLORIDA
COUNTY OF STLUC,E
The forgoing instrument was acknowledged before me
this —a day of 407 ¢ 20,Aq by
BRIAN J MALONEY
Name of person making statement
Personally Known x OR Produced identification
Type of Identification
Produced
nature of Notary Public ate of Florida }
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