HomeMy WebLinkAboutpermit 5709 university lnALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
an
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:
L-m'
Address: nci Q n -
_5:2
Legal Description: Gi oo<A Un
Property Tax ID #: 13 a I — G a y` 0 1 ci_q Do - 0
Lot No.
Block No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additionalwor to b rtormed under this permit - Efieck all apply:
OHVAC ❑Gas Piping Shutters a Wind ows/Doo s
Gas Tank
11 Electric Plumbing Sprinklers Generator Roof
.1 Roof pitch
Total Sq. Ft of Construction: _ _/O Scl. Ft. of First Floor:
Cost of Construction: $ 1j& 50 Utilities: 0 Sewer 0 Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name re,
Name: Yl ors
Address: 7Q� r/v J �.U"
City; 0 " t e-CAStater't
Zip Code:!31SL9/ Fax:
Phone No. 30Y ' 71J -.5-1-1
Company: TREASURE COAST ROO ING
Address: 1816 SW BILTMORE STREET
City: ►44— State: FL
Zip Co e: 34984 Fax: 772-343-8368
Phone No. 772-370-9770
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: TCROOFINGLLC@GMAIL.COM
State or County License: CCC1330653
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirea.
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 BILTMORE STREET
Address:
City.
City:
Zip: Phone:
zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to ao the work cmu ii,sW 6uu11 O�
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 tender or an attorney before
commencing work or recording our Notice of Commencement.
i � t
Sign�te caner�Les C tr or as Agent for Owner signature of Contractor/ is se of
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLCUIE COUNTY OF sT LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Z i' day of 20 4 by this day of Zp Ak, by
BRIAN J MALONEY BRIAN J MALONEY
Name of person making statement Name of person making statement
Personally Known x OR Produced Identification Ps
Type of Identification T)
Produced Pi
Signature of Notary Public- state of Florida)
Commission No..G4 311$65 (Seal) C
REVIEWS FRONT ZONING SUPERVISOR I
COUNTER REVIEW REVIEW R
DATE
RECEIVED
DATE
COMPLETED J_
Rev. 8/2/17
P r: of Florida
Expires
i3. 2023