HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �' I I % Permit Number: l + oO�1�
s
ERECE:IVED
N 0
BU �ri� ermit Application 18Planning and Development Services Counrmittin
Building and Code Regulation Division g
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 46�_1578 Commercial Residential x
PERMIT APPLICATION FOR: Roiof
PROPOSED IMPROVEMENT LOCATION:
Address: 8207 BAYARD ROAD I
Legal Description: LAKEWOOD PARK UNIT 5 BLK 55 OT 19
Property Tax ID #: 1301-605-0371-000-5 I
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION 'OF WOR
_ Right Side: _
Left Side:
TEAR OFF EXISTING ROOF AND IN, PEEL N STICK AND 5 V METAL ROOF
Lot No.19
Block No. 55
CONSTRUCTION INFORMATION:
Additional work to e nP rmed under tispermit—check
11HVAC Gas Tank E]Gas Piping
all
apply:
11 Shutters
Q
_
Windows/Doors
11 Electric 0 Plumbing
[]Sprinklers
[]Generator
F]Roof 5�12 Roof pitch
Total Sq. Ft of Construction: 3054
I
S . Ft. of First Floor:
Cost of Construction: $ 5,500.00
I Utilities: 0Sewer D Septic
I
Building Height: �-
OWNER/LESSEE:
CONTRACTOR:
Name Z vy)%,() n I
Name: 60, t-9-
Address: .--03 �
Company: TREASURE COAST ROOFINGf
City: < State:
Addres :C 1816 SW BILTMORE STREET
Zip Code: 0 Fax: 1%.J c/�k- I
City: U State: FL
Phone No. I
Zip Code: 34984 Fax: 772-343-8358
E-Mail:
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) I
State or County License: CCC1330653
it value of construction is $Z500 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: 8207 BAYARD ROAD
Address:
City: State:
City: State:
Zip: Phone I
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _'Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address: 1816 SW BILTMORE STREET I
Address:
City: I
City:
Zip: Phone:
Zip: Phone: I
I
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 HomelOwners 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 arel 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.
I
Signature of Contras or se H d
Signature of wne e/C ntr s Agint for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLCUIE I
COUNTY OF STLUCIE
The forWng instrument was acknowledged bYore me
this a day of lM � 20 IF bl
The for W.ng instrument was acknowledged before me
this �J day of VIAIf��f 20 I& by
,
BRIAN J MALONEY I
BRIAN J MALONEY
Name of person making statement j
Name of person making statement
Personally Known x OR Produced Identification
Personally Known x Produced Identification
Type of Identificatio I
Type of Identification
Produced
�I
Produced
u
7kll
(Signature Nota lic- State of Florida)
(Signature o otary u ri a
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Commission No. FF12 ..•,.,•,•.,,
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Commission No. FF122 s, � �i • Notary$ KE
RUKKE
• Notary Public- '
State
fate of Florida
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CommMy �
c' Commissior 76172da
EViress h ay 76521722
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REVIEWS
FR
OR
PLANS
VEGETATION
SEA TURTLE
MA E
COUNTER
REVIEW
iREVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev.8/2/17 I