HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� 1� Permit Number. i��a'd3aa,
RECEIVED
Building Permit Application DEC 17 'L,018
Planning and Development Services
ST. Ld@i rfilltiF pfR1lttltlt3
Building and Code Regulation Division ___ _ _ _ . �1 ,
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION
Address: C)g55 Cl e,/Yvna✓ly C &,e1cJ
Legal Description:_ 5Zro�37 F�r"1 M6 C r 'aS¢C PP,/� W AEG T, 0 G
. _ _ _ � r __L
Property Tax ID#: Lori- 1 Lt� ate) O�O�J`~
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Lot No.
Block No.
L DETAILED DESCRIPTION OF WORK:
o-( e,)65-1 ing rood 0 ,d ia5}zU rLew 5� ^u e t +`a s 6 SCANNED
Ti }Jvil}-ur,clgyww,b. BY
St. Lucie County
CONSTRUCTION INFORMATIONS
rt.r.na u,nr fn o nP nrmP iindarthm nPrmit—(' Pf all that ann v_
❑HVAC ❑Gas Tank
Electric ❑ Plumbing
Total Sq. Ft of Construction: o.T 4 6
Cost of Construction: $ 90c1-50
Piping
❑ Shutters❑
Windows/Doors
nklers
❑ Generator
N
Roof
2
Roof pitch
Sty. Ft.. of First Floor:
L Utilities: ]Sewer ❑Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name i
Name:
0_14
Address: C', y S .ram n ha4 P.J •
Company: TREASURE COAST ROO NG
City: �)nri s • Luc- e, State: FG
Zip Code: 3q 9 gy Fax:
Phone No. C, 1(` — 010 3
Address: 1816 SW BILTMORE STREET
City: �) -,n 64 TURI i e. State: FL
Zip Code: 34984 Fax: 772-343-8358
Phone No. 772-370-9770
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: TCROOFINGLLC@GMAIL.COM
State or County License: CCC1336653
If value of construction Is 52500 or more, a RECORUEu Notice or commencement is regwreu.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:- I
MORTGAGE COMPANY: _ Not Applicable'
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: 1816 SW BILTMORE STREET
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:_
Address:
Zip: 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. 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 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,
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
commencine work or recordine vour Notice of Commencement.
Signature of Owner/ L ssee/ I ctor as Agent for Owner
Signa ure o Contractor/Licen a Hol
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST LCUIE
COUNTY OF STLUCIE
The forgpoing iwas acknowledged before me
/'
The forgoing instru entas acknowledged me
lnnstrumgQt
this M day of /3 201 b
this day of De -Ca- 20a by
BRIAN J MALONEY
BRIAN J MALONEY
Name of person making statement
Name of person making statement
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Z fir e �Q
6%� /Z dm�_
(Signature of Notary Public-Stat f Florida )
(Signature of Notary Public- Sta of Florida)
Commission No. 21 J7_ (Seal)
�� r/�
mission No.UtTa 7 2_ (Seal)
or, NotaryPublic Slate of FIon
a
Alterizl0
n" Notan, Public State of Florida
REVIEWS
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VEGETATION
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COUNTER
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17