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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/2116 Permit Number:
s=: � J L 1 10 Tcl ILI RECEIV.H SEP 10 2017
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 Residential x
PERMIT APPLICATION FOR: Roof -
PROPOSED -IMPROVEMENT LOCATION:
Address: 12050 TWIN CREEKS DRIVE
Legal Description: TWIN CREEKS 1 LOT 1
Property Tax ID #: 2333-601 -0001 -000-1 Lot No.1
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
TEAR OFF EXISTING ROOF INSTALL PEEL N STICK UNDERLAYMENT AND 5 V METAL ROOF
PITCH OF ROOF IS 5/12
CONSTRUCTION INFORMATION:
Additional work to b ertormed under tispermit-check
1JHVAC LI Gas Tank ❑Gas Piping
all
that apply:
_ Shutters
a Windows/Doors
11 Electric 0 Plumbing
Sprinklers
M Generator
W1 Roof
Total Sq. Ft of Construction: 4309
S�Ftj. of First Floor:
Cost of Construction: $ 25,500.00
Utilities. LJ
Sewer
F]
Septic
Building Height: 1
OWNER/LESSEE:
CONTRACTOR:
Name ADAM & DELORES TROSKA
Name: BRIAN J MALONEY
Address: 12050 TWIN CREEKS DRIVE
Company: TREASURE COAST ROOFING
City: FORT PIERCE State: FL
Address: 1816 SW BILTMORE
Zip Code: 34945 Fax: N/A
City: PORT ST LUCIE State: FL
Phone No. 772-468-6605
Zip Code: 34984 Fax: 772-343-8358
E-Mail: N/A
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.
L SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
INEER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
State:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
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
commencing work or recording your Notice of Commencement.
s
_ Signature o w r/ ssee gen Signatur of Con r o' se r/ Hol r
STATE OF FLORIDA / STATE OF FLORIDA
COUNTY OF. 49 �iV1 CSC' COUNTY OF , 5&
The forgoing instru nt was acknowledged before me
this day of 20 aby
(Name of perso ckn ledging )
(Signatur N ry Public- State of Flo�id���-RT6',
Personal) Known OR Prodq�tI'
Type of Identificatton Produced a '�
Commission No.
Revised 07/15/2014
";. o, s(Seff 122434
sraTe
'sge�;sge
The forgoing instrument was acknowledged before me
this J day of 20 1 -) by
(Name
(Signat( lNotary Public- State of Florida )
��ff ., ; 41esi9�sr3r,+t
Personally Known OR Produced�I�dsn°itiq
Type of Identification Produced
� • geCommission No. °a�
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REVIEWS
FRONT
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS