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 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 fine
PROPOSED IMPROVEMENT LOCATION:
Address: 10 $ 1adrn4.- 0 F.
Legal Description: _Cndian � i Q,r i-a t 6 Gk 13 Lra S yd
Property Tax ID #: 3 Oct - ; 07 - 00 67- 00a r3 Lot
Site Plan Name: Block No. /d
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
r^Vo-P and in5�Q11 new S�a�,d��9 5ea�+S
I've a/ Zin; car.01 UA dPIr 10.4rhtn .
Aaaitional worK to bffGasTank
rtormed under this permit , c ec a app y:
11HVAC ❑Gas Piping _ Shutters Windows/Doors
11 Electric ElPlumbing ❑Sprinklers ❑ Generator Roof 5 /02 Roof pitch
Total Sq. Ft of Construction: 83 5 7 S . Ft. of First Floor:
Cost of Construction: $ %16 000 Utilities: Sewer ❑Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Nameia/J dlCr Name: br�C
Address: D 01 Company: TREASURE COAST ROOFING
City: ier .e, State: F Address: 1816 SW BILTMORE STREET
Zip Code: 3e/9 $a Fax: City: Pbrl "G State: FL
Phone No. 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
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Ad d ress: 1816 SW 13ILTMORE 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.
Signature of Owner/ ess&¢Contractor as Agent for Owner
Signature of Coutr t?�/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST LcuIE
COUNTY OF ST LLJCIE
The forgoing instrument was acknowledged before me
this day of 5P 12�- 20 -6 by
The forgoing instrument was acknowledged before me
this 2 3 day of SPA 202!�Oby
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
Produced
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(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of lorida )
Commission Na. (Seal)
Commission No. (Seal)
Victor G Alterizip
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DATE
RECEIVED
DATE
COMPLETED
Rev. S/2/17