HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST:BE COMPLETED.FOR APPLICATION TO BE ACCEPTED
Date-7I`'6` l V5 11 Permit Number:
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�ECE `":D JAN 0 5 'l7
Building �ermit 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 x
PERM ITAPPLICATION FOR: Roof - ! .
PROPOSED IMPROVEMENT LOCATION
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Address: '��aCod �LO�rtia1 w�d1 S f
.Legal Description: ra,1,r-LJa4 �QAdjl®!rl _/r_ai!
Property Tax ID#: .Soo--- -0a35 - no 0 - Lot No. /3
I Site Plan Name: Block No.T
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK .
TEAR OFF EXISTING ROOF. INSTALL-NEW ROOF WITH PEEL N STICK
UNDERLAYMENT �/�
CONSTRUON INFORMATIO CTI N
Additional,wor to boeoerformed under this permit-check all apply:
L�HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: J�� o��� S .Ft.of First Floor:
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I Cost of Construction:$ / G Utilities:11 SewerO Septic Building Height: 1
OWNER/LESSEE F, CONTRACTOR:
Name 1- / AYE Name: BRIAN J MALONEY
Address: 9CC O //Zga.4 di;q rile Company: TREASURE COAST ROOFING
City: .ft. State:FIL Address: 1816 SW BILTMORE
Zip Code: ' 3'191 6 Fax:N/A City: PORT ST LUCIE State.FL
Phone No. Zip Code: 34984 Fax: 772-343-8358
E-Mail:NIA 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 1s$2500 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: Address:
City: City:
Zip: Phone: Zip: Phone:
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.
//_�L?_J 7, s
Signature o wner Le ee/Agent Signature of Co ctor/ is nse older
I
STATE OF FLORID AA,, STATE OF FLORIDA
COUNTY OF csc- COUNTY OF Sk- L.aci P
i
The forgoing instrument was acknowledged before me The forgoing instrummnt was acknowledged before me
this day of O-V-1 20 aby this q day of , ) c'`r1 120 _Q by
(Name of person ac o 11 ging) (Name of person wledging)
(Signature blic-State of Florida) (Signat of o ry Public-State of Florida)
Personally nown _OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
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Commission No. �;� ��( ' 'F °py� Commission No. (sad P,RUON
NkF','s,��
201g�9F °• m Q o•��gSl N F o�°°
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Revised 07/15/2014
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DATE
COMPLETE
INITIALS