HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /l/
Date: 212/16 Permit Number: /((d//,, os' 07's �
Building Permit Application MR 2 4 2016
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 Residential x
PERMIT APPLICATION FOR: Roof
:PROPOSED IMPROVEMENT LOCATION.'
Address: 7906 Pensacola Rd
,Legal Description: Lakewood Park unit 6 Blk 65 lot 2
PropertyTax ID #: 13b)606-0146-000-2 Lot No. 2
Site Plan Name: Block No. 65
Project Name: Pensacola
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK.
TEAR OFF EXISTING ROOF. INSTALL NEW 5 V METAL ROOF WITH PEEL N STICK
UNDERLAYMENT qld-,?
CONSTRUCTION INFORMATION:
Additional
HVAC or to e ertormed 0 Gas Tank under
this Gas Pipingc
ec a t at apply:
_ Shutters
C
Q Windows/Doors
0 Electric 1 Plumbing
Sprinklers
I Generator
[z Roof
Total Sq. Ft of Construction: 3556
S Ft. of First Floor:
Cost of Construction: $ 7,000
Utilities: Sewer 11 Septic
Building Height:
OWNER/LESSEE `.
CONTRACTOR: ,
Name Zblgniew Piszcek
Name: BRIAN J MALONEY
Address: 7906 Pensacola Rd
Company: TREASURE COAST ROOFING
City: Fort Pierce State: FL
Address: 1816 SW BILTMORE
Zip Code: 34953 Fax: N/A
City: PORT ST LUCIE State: FL
Phone No.
Zip Code: 34984 Fax: 772-343-8358
E-Mail: NSA
Phone No. 772-370-9770
Fill in fee simple Title Holder on next page (if different
E-Mail: TCROOFINGLLC@GMAIL.COM
from the Owner listed above)
State or County License: CCC1330653
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. / `1/ YL1, 0
S`UPPLEMENTAL_CONSTR'UCTION�LIEN LAWINFORMATIO'N' ,
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:
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
ork or recording vour Notice of Commencement.
_ Signature of Own / Lesse /Agent
STATE OF FLORIDA
COUNTY OF 6+ Lv ,l'e.
The forgoing instrument was acknowledged before me
this."dayof rnAfG4• 20 /.by
C J 1' `A.
(Name of person acknowled
(Signature ofkdotary P - State of Florida )
Personally Known )_ OR Produced Identification
Type of Identification Produced
Commission No. �(�@)iillit/it
ROBER f",
:s r' fty,
S
Signature of Co6fractooticense Holder
STATE OF FLORIDA ,
COUNTY OF 54 Lu G, 'c
The forgoing instrument was acknowledged before me
this day of M&re V: 20 -& by
Personally Known cX OR Produced Identification
Type of identification Produced
Commission No. (Seal)
t,~ May 12 4, -, -'� \`�`� nvt1FR� •r,�,
Revised 07/15/2014 =z �O� 9 � ; GoM'Q. <95
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