HomeMy WebLinkAboutPERMIT 5015 PALMETTO DR (2)ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL .39982
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:
Address: 1.1 M
li Cf%Alt to 4—) Y I•
Legal Description: inAi a" l'G. ; U q_r-
Property Tax ID #: 0 a �a' oz a — Lot No.
Site Plan Name: Block No. _
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
car pf C-Cis�In r00T 0"a vns�ckll V) t,w Shinc�les
anc� un�Q'rla4m k'
CONSTRUCTION INFORMATION:
Additional work lobe Derformed under
this permit —Check
Piping
all appiy:
Shutters
Q Windows/Doors
HVAC Gas Tank[]Gas
Company: TREASURE COAST ROOFIN
`�
Address: 1816 SW BILTMORE STREET
0Electric ® Plumbing
Sprinklers
LJ Generator
R1 Roof Roof pitch
Total Sq. Ft of Construction: V8..2
S Ft. of First Floor:
19J.,000
0
Height:
Cost of Construction: $
Utilities.
Sewer Septic
Building
OWNER/LESSEE:
CONTRACTOR:
Name / CrrAx
Name: n e
Address: Sn f 15�
Company: TREASURE COAST ROOFIN
City:nci�k + PSL State:4
Zip Code. 3q jcga Fax:
Phone No. :3CZ�E `301
Address: 1816 SW BILTMORE STREET
City: ) 6 5 Mate: FL
Zip Code: 34984 Fax: 772-343-8358
Phone No. 772-374-9770
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 52500 or more, a REGVRDLo Notice or commencement is regwrea.
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 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
rnmrnpnrina work or recordiniz vour Notice of Commencement.
Signature of Owner/ Lessee/CPror asAgent for Owner
STATE OF FLORIDA
COU NTY O F ST LCUVE
The forgoing instrument was acknowledged before me
this /.Z day of 20,24 by
BRIAN J MALONEY
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Signature of Contrac Lice s older
STATE OF FLORIDA
COUNTY OF ST MGM-=
The#or oing instrument wa acknowledged before me
this day of C 20,20 by
BRIAN J MALONEY
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Produced
a u of Notary Public- State of Florida ) v
i;5 nature of Notary Public- State of Flor'
Victor G Aiterixt 2 � �/� ri �
Commission No. 751 (Seal) public, State o EJ®5120' n No. (Seal}
Notary
My Commission Expires } 14292
Corr+n►iaa+on No- (3G 27 Victor G Altarizio
m i ]res 11
REVIEWS FRONT I G��- SUPERVISOR PLANS VEGETATIO S T °M
COUNTER REVIEW REVIEW REVIEW REVIEW R EW
DATE
RECEIVED
COMPLETED
Rev. 8/2/17