HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 212/16 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 Residential x
PERMIT APPLICATION FOR: Roof
PROPOSED "IMPROVEM:ENT LOCATION:
Address: % .
Legal Description: kl i 19,r CC c,G S i g
J -`fa OX w '/a !.-,s1b rn
Property Tax ID #: Lot No. `7
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be nertormed under t is permit— Check all apply:
0HVAC Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
1 Electric Plumbing U Sprinklers F� Generator ZRoof 5/ I a
Total Sq. Ft of Constructions: 3q5V Sq. Ft. of First Floor:
Cost of Construction: $ J I 6 Utilities: Sewer D Septic Building Height:
OWNER/LESSEE:.
CONTRACTOR:
Name n
Name: BRIAN J MALONEY
Address:J f Q Q i ve"S� •
Company: TREASURE COAST ROOFING
City: Ir0r I ie)rQ& State: FL
Address: 1816 SW BILTMORE
Zip Code: 5 7 Yc� Fax: N/A
City: PORT ST LUCIE State: FL
Phone No.
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.
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:
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
commencing work or recording vour Notice of Commencement.
_ Signature of
STATE OF FLORIDA STATE OF UNTY OF (�-i' ��c.� L COUNTY OF FLORIDA,S� 1"&Ck e
The for ping instrument was acknowledged JZefore me
this day of M 03f )! 20 P 1by
Public- State of Florida )
Personally Known OR Produced Identification
Type of Identificatio Produced
The forgoing instrument was acknowledged before me
this l day of � 20 1 —7 by
(Name of
Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification roduced
Commission No. �U8211\11R\ BF(9 f 4p%1,� Commission No. ��roa re e'�
.
201. A
Revised 07/15/2014 ° A° ° c ® Y -0 V W
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