HomeMy WebLinkAboutPERMIT 8216 KIAWAH TRACEALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
i
.W �1111__
Building Permit Application
Planning and Development Services
Building and Cade 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 LOCATfON: _
Address: 8x t (� ! _ i q1r a V 11 i f-p C0-
Legal Description: as [fit U Q,[�D
Property Tax ID l#: 3_ -7 --] 0 S - 0090 000 -- 9 Lot No-35
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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CONSTRUCTION INFORMATION:
Additionai work to b rtormed under this permit —check all apply:
DHVAC Gas Tank Gas Piping _ Shutters 0 Windows/Door
11 Electric ❑ Plumbing O Sprinklers Generator R1 Roof Roof pitch
Total Sq. Ft of Construction: 5s/Q S Ft. of First Floor:
Cost of Construction: $ 3-2, 0o _ Utilities:Ll Sewer OSeptic Building Height:
OWNER/LESSEE:
CONTR OR:
Name �'
Name: Or)
Address: 4/
Company: TREASURE COAST ROOFING
City: Lz u C, State: FG
Zip Code: _3yS8 9 Fax:
Phone No.
Address: 1816 SW BILTMORE STREET
City: 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
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requires.
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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: 1516 SW BILTMORE STREET Address.
City: City -
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR. AFFIDVIT: Apnlication is herebv 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
stlructure. Pleaich is in se consult lict livith w thpyolcableur Home owners ome Association lon and review your deed avjs or for any restrictions venants that which may arestrict orpply. Iblr `u h.
In consideration of the granting of this requested permit, l do hereby agree that l 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,
accessary structures, swimming pools, fences, wails, 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 Iendor or an attorney before
commencing work or recordin our N ice of Commencement,.
i
Signature of Owner) to se Coutr r as Agent for Owner Signature Contra r/ 'c se Holder
STATE OF FLORIDA � STATE OF FLORIDA
COUNTY OF STLCUIE COUNTY OF STUUCIE
The forgoing instrument was acknowledged before me The forgoing instrumen was acknowledged before me
this day of 20X by this c)- ? day of 04 C, 20a 00 by
RiAN ,i iviALoiJEY'
Name of person making statement Name of person Making statement
rsonally Known! x OR Produced identification I Personally Known x OR Produced Identific tion
pe of Identification Type of identification
oduced Produced
ign4ture of Notary Public Sta*e Of rloriA2 } 1 JSignat! re of €�otar�; Public- State lorida 1 a 5 -4
N
mmissinn Na. G ®Z �. (Seal) Commission t�aGG Yi - (Seal) o �
Gim o C
EVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MA G 10
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW RE IQgg a
A 25
RECEIVED
DATE
COMPLETED
Rev. 9/2/17