HomeMy WebLinkAboutBuilding Permit Application I
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ALL APPLICABLE INFO MUST BE.COMPLETED FOR APPLICATION TO BE ACCE TED _
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Date: 2/2/16 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 Reside i tial x
PERMIT APPLICATION FOR: Roof
w•sa. b' _
PROPOSED IMPROVEMENT LOCATION:
Address: 35d AU0, o�.
Legal Description: _�U� �CcY1 a G'1C=G�' 15 ��,�C )q Lv t �, And 33
Property Tax ID#: o����J— Go 0;),G16— n00 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION OF WORK:
Grl 8 B y)S�q j( n_t w �Grn k o Shin le.r
c � L1k16 r Jan--e,,,,4 o J I e_ o � 4 r- 1G 4- A6o� C� C� dd') 5+aK e w
R" V-00k.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check a app y:
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OHVAC Gas Tank ❑Gas Piping _Shutters ❑(Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: j3 5 S . Ft.of First Floor:
Cost of Construction:$_ 9" a O Utilities: Sewer❑_Septic Building Height: 1
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OWNER/LESSEE: CONTRACTOR:
Name ,- P Name: BRIAN J MALONEY
Address: ISO C- Company: TREASURE COAST ROOFING
City: I ot, State:FL Address: 1816 SW BILTMORE
Zip Code: 3CJ Ci y7 Fax:NIA City: PORT ST LUCIE I State:FL
Phone No. Zip Code: 34984. Fax: 772-343-8358
E-Mail:NIA 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: CCCj1330653
If value of construction is$2500 or more,a RECORDED Notice of Commencement is iequired.
SUPPLEMENTAL;CONSTRUCTION LIEN, LAW INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address: 1 .I
City: State: City: I; I State:
Zip: Phone: Zip: I. Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address: I,
City: City:
Zip: Phone: Zip: I, Phone:
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I certify that no work or installation has commenced prior to the issuance of a permit!i
St.Lucie County makes no representation that is granting a permit will authorize the plermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and lcovenants 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
commencing work or recording our Notice of Commencement.
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_Signature o ner Le a Age Signatu of ct nse er
STATE OF FLORID STATE OF FLORIDA
COUNTY OF I�l�l C� COUNTY OF
c The for oin i
The forgoing instru wa cknowledged before me g instrument was cknl wledged before me
this day of 20 oy this day of 20 Ll b
[ MCI
yr7 LUrC
(Name of person ack a g) (Name of person k wledging),
.;: r�13:! dry_ /i/f .•;�1i'9i;iiilidlf
(Signature offibliroN blic-State a Flpfida) Ny1n��° Q;rV�� (Signat o ota`. Public-State of Florit�2ti` °5 i
'ro �. ,�� gApu h
Personally Known OR Prgdu Idelitit c fon Personally Known i. OR ProduceTil�e�tific on��✓fi
Type of Identificatio roduced Type of Identification Produced
Commission No. �;�'�6;( b }'4Nor3o.° Commission No. 'r { �SSINwo�° �R
;i?d k-'0ffi\�l'��`
Revised 07/15/2014
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW I REVIEW REVIEW
DATE
COMPLETE l
INITIALS
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