HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
II SCANNED
Date: Permit Number:
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BY
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Kz ,,...,: St. Lucre OOeanty
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- RECeiveD
Building Permit Application JUN 2
Planning and Development Services R 2018
BJJu. ing and Code Regulation Division Permitting Department
?1300 Virginia Avenue, Fort Pierce FL 34982 S . Lucie County
Rhone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT
APPLICATION FOR: To Select from dropbox, click arrow at the end of line
p,ROP05'ED'
fMPROVEME'NT L'OCATfON
Address:
i s lY cxr Q r- 1 Q LAI,
Legal
Description: el 1'.S h lG �� Pr
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,
Priperty Tax ID #: 3 ,1-11q — S Q 1 " Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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M1
DETAILED DESCRIPTION OF WORK.
,e, a,e- a� I SiI n rd a-ESIon, II n.e W 5v h-Le¢a/
CONSTRUCTION INFORMATION:
Additional work to b M orme under t—checkispermit a appy:
❑HVAC Gas Tank ❑Gas Piping Shutters ❑ Windows/Doors
❑Electric ❑Plumbing ❑Sprinklers ❑Generator Roof s /� Roof pitch
To ral Sq. Ft of Construction: 1 ao o Sq. Ft. of First Floor:
rJ, ❑
Cot of Construction. $ 0�0 Utilities: Sewer Septic Building Height:
OV11N ER/LESS'EE:
._
CONTRACTOR:
Name: 1
Name e.f 4&
Address: !t�, 1Y)ct! i 6 +on 6AJ
Company: TREASURE COAST ROOFING
Ili : I -
Cit i�a d` �- S liUC.(� State:
Address: 1816 SW BILTMORE STREET
Zip Code: 3995 a Fax:
City: State: FL
Phllne No. q sg - SqQ " 760 %a
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
frail the Owner listed above)
State or County License: CCC1330653
If value
I
of construction is $2500 or more, a RECORDED Notice of Commencement is required.
,SUPPLEMENTALCONSTRUCTION'LIENLAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
N1ame:
Name:
�;ddress:
Address:
Gity: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address: 1616 SW BILTMORE STREET
Address:
City:
city:
Zip: Phone:
Zii p: Phone:
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.1Lucie 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,
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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
b"fore the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
I � I ; � P _a -a
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7:�-zj --3-
lignature of O r/ L s on a e ctor as Agent for Owner
ct
Signatu a of Co or Lic se
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLCUIE
COUNTY OF STLUCIE
Tjhe for oing instr ment was acknowledge before me
The f g instrut�t was acknowledged efore me
this �ay of , l�nP 20_by
this day of 201� by
,
l�RIAN J MALONEY
BRIAN J MALONEY
I Name of person ng statement
Name of person making statement
Personally Known x R Produced Identification
Personally Kno_;7wn x OR Produced Identification
,Type of Identification
Type of Identificatio
iroduced
I
Produced
(((Signature of NrryPublic- State of Florida)
(Signature ota - t e f I i
Commission No. FF12224 (Seal)
Commission No. FF 2 Notary Public (%1
,• �;c�s�^ ROBERT BDNotaryAssn.
�I `• 0.Y'PV '. ROBmT BRUNKE �
• . Commission #
:`i SAP: My Comm. Expires
II Notary Public— State of Florida
0,`, ;"' Bonded through NaSo
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tev. 8/2/17