HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL `APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
SCANNED Permit Number:
BY �Fo�
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St. Lucie Countyps�,� G I
Building Permit Application F<GcPoPp.IAp
ing and Development Services 0 d 1,h
hg and Code Regulation Division 1) e
Wrginia Avenue, Fort Pierce FL 34952
e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PER' IT APPLICATION FOR: �Tci
Select from dropbox, click arrow at the end of line
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;cription: V Cm -hJc-e, C'7j4 ce4 1 A� i G Y3 i v Cyr i o
Prop ky Tax ID #: �,fi 1� 5/6 c7Z5yq Z5 c7 a 9 Lot No. 93_
Site.Pl�11
n Name: Block No.
Project Name:
ks Front Back: Right Side: Left Side:
ILED DESCIRIPTION OF WORK;
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CONSTRUCTION INFORMATION:
Additional work t0 be performedoerformed under this permit — check all tthU app v:
'AC L l Gas Tank
!ctric 0 Plumbing
Total Sl . Ft of Construction:
Cost o Construction: $ 5 ,
Gas Piping L _I Shutters
Sprinklers El Generator
S Ft. of First Floor: _
Utilities: Sewer []Septic
QWindows/Doors
® Roof s / Roof pitch
Building Height:
OV1%I�ER/LESS'EE: °.
,
_ _Alker
CONTRACTOR:
Name,..
i
�
Name:
IIII
Address: aS AA .cQ(;�_- !<-it/-C
Company: TREASURE COAST ROOFING
City: 1 tr as � 1-5-lip State:
Address: 1816 SW BILTMORE STREET
Zip Co 11 e: t 17.3 n Fax:
City: State: FL
Phone G3 ( — V0.1— 599.3
Zip Code: 34984 Fax: 772-343-8358
lNo.
E-MaN
Phone No. 772-370-9770
Fill in fie simple Title Holder on next page ( if different
E-Mail: TCROOFINGLLC@GMAIL.COM
from t Ile Owner listed above)
State or County License: CCC1330653
If value;pf construction is $2500 or more, a RECORDED Notice of Commencement is required.
r
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
SIGNER/ENGINEER: — Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
—
Name:
A�oress:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
—
Name:
Name:
Andress: 40-- aw && ----= RE
Address:
••I
Ci
City:
ly:
Zil : Phone:
Zip: Phone:
019NER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I ce ify that no work or installation has commenced prior to the issuance of a permit.
L'; St. �cie 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
stru �jture. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In co sideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in acicordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
Thell ollowing 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
III WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in vour oavine twice for
improvements
to your property. A Notice of Commencement must be recorded and posted on the jobsite
bef'pre
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 Contractor nse
Si
nature of Owner/L6 s Agent for Owner
eyrr
STATE
OF FLORIDA
STATE OF FLORIDA
C
" UNTY OFSTLCUIE
COUNTY CIF- LUCIE
The
fqrping instruywent was acknowledged efore me
s
The for Pl g instrupWt was acknowledged before me
this 2 ZSday V.��.� 20�&by
th
day of ram_ 20� by
of ,
BRAN
J MALONEY
BRIAN J MALONEY
Name of person making statement
Name of person making statement
Personally
Known x OR roduced Identification
Personally Known x 31Produced Identification
T y
e of Identificatio
Type of Identification
ip
Produced
Produced
(Signature
u
o otary ic- State of Florida)
(Signature o Pu c-State of Florida )
FF122434
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mmission No. s ERT BRUNKE
Commissi n No. (@%I BRUNKE
a°, :Notary Public — State of Florida
^•
? _* No Public — State of Florida
'-'
• ; ` Commission # GG 176972
asMa 12.2022
Commission # GG 176972
: q' ° My Comm. Ex ires May 1
Bonded:hro
ghNaSona No:arvAssn.
Binded:hroug
Naiona'No:arvAssn.
REVIEWS
FRONT
P NS
VEGETATIO
-SEA TUMTE'O'
I'I
COUNTER
REVIEW
JEW
REVIEW R_V
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
f�
COMPLETED
tev;18/2/17
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