HomeMy WebLinkAboutPERMIT APP 5009 PINE TREEAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
L` L Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:RE_ROOF
PROPOSED IMPROVEMENT LOCATION:
Address: 5009 PINE TREE DR
Property Tax ID #: 3402-602-007-000-1
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
FEAR OFF EXISITNG ROOF AND ]STALL NEW 5V METAL ROOF AND UNDERLAYMENT.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
Generator
Sq. Ft, of First Floor:
Lot No.34135
Block No. 2
-Windows/Doors _ Pond
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ROBERT KELLLY
Name:BRIAN MALONEY
Address:5009 PINE TREE DR
Company:TRASURE COAST ROOFING
City: FORT PIERCE State: _
Zip Code: 34982 Fax:
Phone No.772-528-3664
Address:1816 SW BILTMORE ST
City: PORT ST LUCIE State: FL
Zip Code: 34984 Fax:
Phone No772-370-9770
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-MailTCROOFINGLLC@GMAIL.COM
State or County License CCC1 330653
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
iid L fi 31 ki 1*
�_.... �-
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: 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorneybefore commencin work or recording your Notice of Commencement.
Signature of Owner/ sse r or as Agent for Owner
Signature of Con act / en Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF s/ Lytie
COUNTY OF Jt one
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
✓Physical Presence or Online Notarization
this -IV day of May 382e by
2411
this _I— day of /a,i , 202q by
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Name of person making statement. S'_z f,a
Name of person making statement. = o n
x
Personally Known,_ OR Produced Ident �GattnrA - iz
Personally Known __ OR Produced Identification
Type of Identification -v,
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Type of Identification
Produced �`� _,
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Produced Xp
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S ature o Notary Public- State of Florida 1
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IS ature of Notary Public -State of Florida)
Commission No. /3 2 (Seal) �,�'� ��o,
No. Ai4
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;Commission (Seal)
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