HomeMy WebLinkAboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Coi..I ilvl�Y
F L 0 R I D if
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: 0, q
Legal Description:
Property Tax ID #: -- -70 S -- <)0,J,9 — 0()d _ 9 Lot No. 3%
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
qtr 0-,O eA I,f �i/�� r�a� Q t cl
CONSTRUCTION INFORMATION:
Additional work to e�ef r Orme un er t is permit — c ec
a appy;
HVAC L�J Gas Tank []Gas Piping
_ Shutters Windows/Doors
Electric Plumbing1:1 Sprinklers
Generator Roof S ` Root pitch
Total Sq. Ft of Construction: 66
S. Ft. of First Floor:
Cost of Construction: $ UtilitiesInSewer
[]Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ,eAz i,%d
Name: I !-iCt✓1 4' r1C
Address: G 5q a ,A-0ZIL,.
Company: TREASURE COAST ROOFING
City: Q5 M S,p C State: F4
Address: 1816 SW BILTMORE STREET
Zip Code: 33 yb Fax:
City: ) 8 t.0 3_ _J J��-� State: FL
Phone No. q6 7— a,i 3 _
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 $2504 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
NER/ENGINEER:
Name:
Address:
City:
Zip: Pho
FEE SIMPLE TITLE HOLDER:
Name:
AddreSS: 1616 SW BILTMORE STREET
City:
/_Ip: Phone:
— Not Applicable
State
Not Applicable
MORTGAGE COMPANY: 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 our Notice of Commencement.
Signat e of Owner/ Les ee/Co actor as Agent for owner Signature 4tractor ense I r
STATE OF FLORIDA
COUNTY OF ST LCUIE
The for o' g instru ent was acknowledged before me
this �ay of �i 2p by
BRIAN J MALONEY
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- Statedaf Florida )
Commission No,{T%?44266- (Seal)
REVIEWS
NTE
DATE
RECEIVED
DATE
COMPLETED
Rev. $/2/17
G Alterizio
STATE OF FLORIDA
COU NTY OF ST LUCIE
The forgoing instrurppnt was acknowledged before me
this"` -,ay of 20pV by
BRIAN J MALONEY
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of FI da )
Commission No F. (Seal)
\NS I VEG TATI
IEW REVIEW