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Home My WebLink AboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE `7ACCEPTED(�-- Date: 1` 0�'�� Permit Number: L-L()I ' DC75 y z Building Permit Application kc; lk Planning and Development Services ✓Qy Fo Building and Code Regulation Division PON 0 g 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial - Residential�4`��cpdn PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III PROPOSED IMPROVEMENT LOCATION: Address: SCANNED or Legal Description:- _At -ea AC;r4_6 R 610 r^nrrn �� Property Tax ID #: ,iv5 — pOl — 0053 — <3o6 — q Lot No. _ Site Plan Name: Block No. c1 Project Name: Setbacks Front Back: Right Side: LeftSide: DETAILED DESCRIPTION OF WORK: III 5 a„ L+ q.+d Stc.-•1 0) 6 C^d (/' ?V, 6Yr CONSTRUCTION I HUUr LIU[rdr wurA LU ue OHVAC pCrlvrrneu urrUer Ln rJ UJ Gas Tank OGas IJer If rrl—U Piping 11 Electric 0 Plumbing Sprinklers apply: Shutters ❑Windows/Doors Generator © Roof W Roof pitch Total Sq. Ft of Construction: `7 %tU S Ft. of First Floor: Cost of Construction:$ CnI��J�� Utilities:SewerOseptic Building Height: OWNER/LESSEE: CONTR OR: Name Y Name: 21 H/v N Address: S O ( I W i rl. Company: TREASURE COAST ROO ING City:TD—Ir) S. L%jcle, State:P6 Zip Code: 3q 3 �% Fax: Phone No. U01 - 3c(! ` 3$ r. Address: 1816SWBILTMORE STREET City: �. S L - State: FL Zip Cade: 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: CCC1330653 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable Name: Address: 1816 SW BILTMORE STREET Address: City: City: Zip: Phone: 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 Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conWict 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 _ w Y �V V Signatu Owner/ Less /Con p for as Agent for Owner STATE OF FLORIDA COUNTY OF ST LCUIE The forgn Yinstrumetacknowledged me this aof NAJ 261by BRIAN J MALONEY Name of person making statement Personally Known x OR Produced Identification Type of Identification STATE OF FLORIDA COUNTY OF STLUCIE The for Ing instrument was acknowledged before me this day of 11; -h 20-4 by BRIAN J MALONEY Name of person making statement Personally Known x OR Produced Identification Type of Identification Produced (Signature of Notary Public- a of Florida) (Signature of Notary Public- State of F19i Ida ) Commission No.4gg 274-1 9,)- _ (Saal) _ _ _ _ _ _ _ _ Commission No.�o2 (Seal) Notary Public Staid of PlonW REVIEWS FRONT COUNTER DATE RECEIVED DATE COMPLETED Rev.8/2/17 VEGETATION REVIEW