HomeMy WebLinkAboutPERMIT 170 SE CALMOSO DRALL 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
2340 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
Residential
PERMIT APPLICATION FOR: To Select from dropbax, click arrow at the end of Eine
PROPOSED IMPROVEMENT LOCATION:
Address: 1 i 4 45 6 C A (n1a - r
Legal Description: '_ \W qx-c�Ctr k Vit1 t -1 [� k a <I L
Property Tax I D #: 3 W 9— 61S a 0 O 3 R 0 a 0 1
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
4 1q
Lot No. //I q b
Block No. 7
DETAILED DESCRIPTION OF WORK:
a i a,T d m fl ayl 5V Mad
CONSTRUCTION INFORMATION:
itiana wor to a er orme un er t ispermit - check all that app y:
HVAC Gas Tank 0Gas Piping 1:1Shutters 0 Windows/Do rs
LSI Electric Plumbing Sprinklers F� Generator Z Roof 411 I Roof pitch
Total Sq. Ft of Construction: ��d S . Ft. of First Floor:
Cost of Construction-$_ 15'4 _W_ Utilities: Sewer Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name O
Name:
Address:11 !?D a m //.
Company. TREASURE COAST ROOFING
City: 0 �T State: 'P'4_
Zip Co e: gc4q Q3 Fax:
Phone No.
Address: 1$16 SW BILTMORE STREET
City: ,r-& State: FL
Zip Code: 34984 Fax: 772-343-8358
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
VO UC t-V„au uLl,ev11 l20,?cauv or more, a Kr_LU euro Nonce or 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:
Address: 1816 SW BITMORE 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 ail 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 your Notice of Commencement.
Signature of owner/ 4i:gee/ractor as Agent for Owner Signature of ntractor[ Ui6se
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LCUIE COUNTY OF ST LUCIE
The for oing instrument as acknowledgeg_before me
this day of _ 0 20o,'F 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 Florida )
Commission No, ry! J74�> 1J. (Seal)
UNTER
DATE Notary uu-, ,
RECEIVE My Carom S. E ra I
COMPLEI
Rev. 8/2/17
The forgoing instrument was acknowledged before me
thiscZday of Q 2Ca, 70 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 Fio a )
F�
Commission No. (Seal) Victor G Alteri;
Notary Public, State i
My Commission Expires
PLANS REVIEW I VEGETATION S REVIEW LE MANGROVE