HomeMy WebLinkAboutBuilding Permit Application APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater 151 9 Permit Number:
_ Lv � Y'=` DECEIVED JAN 0 5 NUa7
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 x
PERMIT APPLICATION FOR: Roof - rn V'A q\
PROPOSED IMPROVEMENT LOCATION:
Address: 11W'' i
Legal Description: [? 1PCL5 —7
PropertyTax lD#: ,%at _.,%l 1. a a — ! Lot No.
Site Plan Name: Block No. C,
Project Name:
Setbacks Front Back: Right Side: Left Side:
DE;TAFLED DE,.
TEAR OFF EXISTING ROOF. INSTALL NEW ROOF WITH PEEL N STICK
UNDERLAYMENT rase it
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all apply:
11HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing []Sprinklers CGenerator 21 Roof
Total Sq.Ft of Construction: Li/ 9 4 3 S .Ft.of First Floor:
Cost of Construction:$ 9 C7 o b Utilities:11 Sewer OSeptic Building Height: 1
OWNER/LESS'EE •, "'"CONTRACTOR;
Name Name: BRIAN J MALONEY
Address: TZt. Company: TREASURE COAST ROOFING
City: State:FL Address: 1816 SW BILTMORE
Zip Code: 3C19X_? Fax:NIA City: PORT ST LUCIE State:FL
Phone No: Zip Code: 34984 Fax: 772-343-8358
E-Mail:N/A 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. a,1k.1 4,3
PPLEMENTAL 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:
i
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.
7(
—Signature of w er ee/Agent Signature of Co ra r/Lice older
STATE OF FLORIDA STATE OF FLORID
COUNTY OF ,s�/�S',((� COUNTY OF ���' /�A.G o
The folding instrument was acknowledge before me The forgoing instrument was acknowledged before me
this, day of ,� CJ►�1 20 y this day of J G .20 by
2C^-pC� ' Irk r ^ J 1�uct lw�
-
(Name of person ac ing) (Name of person owledging)
(Signature No Public-State of Florida) (Signat tary ublic-State of Florida)
Personall no n OR Produced Identification Personally Known OR Produced Identification
Type of Identificatio duced Type of Identificat' n Produced
J 5RtJAJ®or'r�y .��d1919111a►drre
Commission No. zr` •' )S�ONF p��° ,`'� Commission No. ®�� iT BRUNao��P,
JV °
Revised 07/15/2014 o a c . ^
�1_11 °.•°BuC ondeds0�°•.B Ba N. s °°Qti
REVIEWS FRONT ZO �4y R PLANS VEGETATION SEA
COUNTER REVINE1 rir f�� ;c Q`�W REVIEW REVIEW REVIT=eU•°S7 • �`
DATE
COMPLETE
_T JI
INITIALS