HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONis I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED D c D
Date' Permit Number: —�
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-I_ ----- Building Permit Applicatio ��� ® 3 2o1B
Planning and Development Services tffie�i
Building and Code Regulation Division �;<t1�4ey F1-
2300 Virginia Avenue, Fort Pierce FL 34982 perm�r
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial R Sidgloti�iCl t
PERMIT APPLICATION FOR: Roof
-PROPOSED IMPROVEMENT LOCATION:.
.n �anwnn
Address: -S L/ ! g L on-6 64'C' -(j C'4 . Ludy COMP
I
Legal Description: 6G VG rl'na
Property Tax ID #: 3�/o�,�j- `� C73 000 - `-1 Lot No. 9
Site Plan Name: Block No. - V
Proiect Name:
Setbacks Front Back: Right Side: Left Side:
DETAILEDbESCRIPTION, OF WORK:'"',
�2G►� O-� 2k�5-Ein�c road' c,,,rj nS�G�[' ,�e,,� v+Ci;nS --Vrt
a C) 5 y g �,+s C,.,) off) L
CONSTRUCTION INFORMATION:
Acid Mona I worK to be n,rtormed under tis permit -check all apply:
LIHVAC u Gas Tank []Gas Piping In _ Shutters Q Windows/Doors
[IlElectric 0 Plumbing Sprinklers I Generator F;] Roof 5 /a• Roof pitch
Total Sq. Ft of Construction: a.a I
Cost of Construction: $ /5i.30 O
S Ft. of First Floor: _
Utilities:OSewer OSeptic
Building Height:
OWNERAESSEE`: "
CONTRACTOR:
Name cl vrae i v
Name: r)-Zia-% M'40--uy
Address: 1 y-7 C4
Company: TREASURE COAST ROOFING
Address: 1816 SW BILTMORE STREET
City: '?o4 54. Luc' State: CG
Zip Code:3</`7' SdL Fax:
City: )�-�j r� ,S GdG it-G State: FL
Phone No. 77,L -- 3`/d — YS 70
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)
State or County License: CCC1330653
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
T
,SUPPLEMENTAL CONSTRUCTION LIEN LWIN
..
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address: 1816 SW BILTMORE STREET
Address:
city:I
City:
Zip: Phone:
Zip: Phone:
I
!R/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
F that no work or installation has commenced prior to the issuance of a permit.
County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
e. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
deration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
dance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
owing building permit applications are exempt from undergoing a full concurrency review: room additions,
ry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
IING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
cements to your property. A Notice of Commencement must be recorded and posted on the jobsite
the first inspection. If you intend to obtain financing, consult with lender or an attorney before
encine work or recording vour Notice of Commencement.
I
Signature of Owner rac ess e/ onts Agent for Owner
Signatur of Con_tra-(Tb"r/(5Ase
H er
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLCUIE
I
COUNTY OF STLUCIE
The fpcgoing instru ent was a knowledge efore me
this day of 20A by
The f oing instr ent was
this day of
knowledged before me
20 by
I
BRIAN J MALONEY
BRIAN J MALONEY
Name of person m statement
Personally Known x OK Produced Identification
Type of Identification
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Produced
I
Produced
i
(Signature of No u Ic-S a
COm ission No. FF122434
�,a) ROBERTBRUNKE
Notary Public— State of Flo
L I ommission#Gd17697
$p� �'
`Nly Comm, Expires May 12,
Bonded trough Nadcrta 14 2,
nature of a P `pig) I NKE
ry t —State of Florida
' ` Commission # GG 176972
de
C mission No. ,,�"'MYComm.
FF122 OFP4�. (�J@May 12, 2022
22 Bonded mrough Nedona! Natarygs�n,
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Rev. 8/2/17