HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL AF
Date:
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
SCANNED Permit Number: A01 • Q&&
BY
Sao Lode W*
RECEIVED
Building Permit Application
Plannin I and Development Services JUI. 12 :Z018
Buildin��and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof
PROPd$Ebi IMPROVEMENT LOCATION
Address: Oi /-J GY -0-C., V j
Legal Description: f o,� l i qx C� �lka' �-e 55 f
Property 1 ax ID #: 1513,6 _ Co I " 304 / -- (3 (16 — J Lot No.
Site Plan I ame: Block No. 3
Project Name:
Setback Front Back: Right Side: Left Side:
DETAIL D DESCRI"PTION OF WORK:
III a,✓ ai eki3�jn� ��,� c�nd rn3�a�1 n� .SV d'�ey(q,� G'', d
CONSTRUCTION INFORMATION: .
Addition6 wor toberiertormed under this permit check all apply:
IIHV C L_—I Gas Tank Gas Piping Shutters a Windows/Doors
11 Elei Itric 0 Plumbing Sprinklers Generator Q Roof /a Roof pitch
Total Sq. �,t of Construction: 3d3! So. Ft. of First Floor:
Cost of Cohstruction: $ l Utilities: Sewer Septic Building Height:
I
,'0W N EAVLESSEE:.
CONTRACTOR:
Name
I1IF-4,12&r i'�ii✓l,�iC�hd S%l
Name: rjc✓1 C
I �11�� agb
Address:
City:
Company: TREASURE COAST ROOFING
Address: 1816 SW BILTMORE STREET
r r4 '7 F.rCA, State: fL
Zip Code:
y 91 q Q Fax:
City: D�4 5 • tuCi L State. FL
Phone No
Y(37 — cf 63 — a3z)sj
Zip Code: 34984 Fax: 772-343-8358
E-Mail:
Phone No. 772-370-9770
imple Title Holder on next page ( if different
Fill in fee
E-Mail: TCROOFINGLLC@GMAIL.COM
from the
Owner listed above)
State or County License: CCC1330653
If value of 4onstruction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPyEMENTAL CONSTRUCTION LIEN LAW INFORMATION:,
ER/ENGINEER: Applicable
MORTGAGE COMPANY: Not Applicable
_Not
NamIe :11Name:
_
Addre "s:
Address:
City: �� State:
City: State:
Zip: I Phone
Il
Zip: Phone:
FEE SIMPLE
TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name
!1
Name:
Address:
Address:
City:
City:
11 Phone:
I
Zip: Phone:
Zip:
OWNER% CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify Iftat 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 accord'' nce with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The follo, Ming building permit applications are exempt from undergoing a full concurrency review: room additions,
accessor)I 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 he first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencin work or recording our Notice of Commencement.
SignalIe
of Owner/ Le a /Contr as Agent for Owner
Signature of Contractor/Licens older
STATE,
OF FLORIDA
STATE OF FLORIDA
COUNTY
OF STLCUIE
COUNTY OF STLUCIE
The fo
oing instrt�ent was acknowledged] before me
The fo oing instr m t was acknowledged before me
this day of 20JA by
this
ay of _ 20 d by
BRIAN J
IMALONEY
BRIAN J MALONEY
Name of person making statement
Name of person making statement
Personally
Known x OR roduced Identification
Personally Known x OR Produced Identification
Type o1
Identificati
Type of Identification
Produ
ed
Produced
(Signa lure
o Pu ic- State of Florida)
(Signature 0Public- State of Florida )
Comm
FF122434 "i}4 s'''• I ROBERTBRUNKE
ssion No. _ °, ,�:':� Oti R Public of Florida
ommission No. FF122434'+,
BRUNKE
_, •�. ,:
a ; Commission # GG 176972
q My Comm. Expires May 12. 202
+ +''; Note
'. . ,1 rY Public—Florida
v ; State
fM Commission # GG
cF
_� 7
176972
1016.
Bonded through Ilaticnal
22
REVI
WS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
S A
V
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIE
DATE
RECEII
ED
DATE 1
COMPLETED
Rev. 8/'
17