HomeMy WebLinkAboutBuilding Permit Application 4
ALL APPLI ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:I
3 -1 Permit Number:
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 xxx Residential
PERMIT APPLICATION FOR: Roof —C,OEl
vv�
PROPOSED IMPROVEMENT
,LOCATION
Address: 4100 N A1A, FORT PIERCE 34949 BLDG 4
Legal Description: TREASURE COVE DUNES A CONDOMINIUM COMRISING A PART OF SECTION 23 TOWNSHIP 34 RANGE
40 ALL MPD AND SHOWN IN DECLARATION OF CONDOMINIUM OR 385-980(4.15AC)(OR 385-980)
Property Tax ID#: 1423-502-0000-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK`..
x
RE-ROOF 48 SQ TPO 9 SQ LIQUID PMMA
CONSTRUCTION INFORMATION
Additionalwork to Oe nertormed under t is permit—check all apply:
0HVAC M Gas Tank Gas Piping In_Shutters ❑Windows/Doors
❑Electric ElPlumbing Sprinklers []Generator Roof FLAT Roof pitch
Total Sq. Ft of Construction: 4800 S Ft.of First Floor:
Cost of Construction:$ 389,900.00 Utilities:Sewer E]Septic Building Height:
OWNER/LESSEE CONTRACT OR n
TREASURE COVE DUNES CONDO ASSOC INC RAYM K_
Name Name: OND SMITH
Address:4100 N Al Company: G&G ROOFING CONSTRUCTION INC
City: FORT PIERCE State:FL Address: 456 GUS HIPP BLVD
Zip Code: 34949 Fax:772-286-2996 City: ROCKLEDGE State:FL
Phone No.772-286-2990 Zip Code: 32955 Fax: 321-301-4471
E-Mail:MICHAEL.WEBER@ALSIGROUP.COM Phone No. 321-301-4470
Fill in fee simple Title Holder on next page( if different E-Mail: INFO@CFLROOFING.COM
from the Owner listed above) State or County License: CCC1329326
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INF. RMATION=.
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 wi._le der- orney before
commen.cin wo or ordin our Notice of Commencement.
�a S
Si Pure of 0' r/Less Contractor as Agent for Owner ignature o Factor/Liccr��e H r
STAOt R1DA ORIDA
C NTY OF:`( COUNTY OF , zur1�—c�
Th or going instrument was acknowledged_before me The forgoing ins ument was,acknowledged before me
this\ day of \(`�CUv'� 20 0,by this Ct day of tCt-r ,_, 20 1--1 by
(Name of kerson acknowledging) (Name o rson acknowledging)
(Signature of Notary Public-S to of Florida) ! (Signature of Notar ublic-State of Florida )
Personally Known _OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. awa =A M�E RAYE KHOURY Commission No. DAL gIMYE KHOURY
NO AR PUBLIC NOTARY PUBUC
STATE OF FLORIDA STATE OF FLOMDA
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Revised 07/15/2014 9 Expires 4/17/2018 Expires 4/17/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE J N
INITIALS � !