HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: . �� • SCANNED Permit Number: I
BY RECEIVED
St. Lucie County
Building Permit Application I MAR 2 6 2019
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
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Address: ilS."N AIGvn,-.
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Legal Description:�`�)/¢v- v
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Property Tax ID #: 3,t-I) 4- SWO — t)159- Uoo -3 Lot No.a4
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION: III
Aaanional worK to neve orme un ert isDermit-check all that aDolv:
L=JHVAC L J Gas Tank UGas Piping
Electric 0 Plumbing ❑Sprinl
Total Sq. Ft of Construction: - j
Cost of Construction: $ 7 , 6 0 b
Shutters Windows/Doors
Generator Roof S a Roof pitch
S Ft. of First Floor: _
Utilities:n Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Cg%4VtLrae%c,
1A_rra
Name: Ca
Address: �L5 :rn w TNr -
Company: TREASURE COAST ROOFING
City: • 1Q. StateTnj
Zip Code: S Fax:
Phone No. 95I —41 d— Y6a6
Address: 1816 SW BILTMORE STREET
City: 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: 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: 7816 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 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 lobs'te
before the first inspection. If you intend to obtain financing, consult with lender or an attorney befor
c_ ommencing,york or recording your Notice of Commencement.
101 - / I ,
as Agent for Owner
STATE OF FLORIDA
COUNTY OF ST LCUIE
The for oing instrument was acknowledged before me
this gK dayofdfdre4 20/14 by
BRIAN J MALONEY
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Produced
.1_4 �
(Signature of Notary Public- State of orida )
Commission No. % c0 02 (Seal)
Public State
REVIEWS I FRONT
COUNTER
Ha1l:1
I COMPLETED
Rev.8/2/17
STATE OF FLORIDA
COUNTY OF STLUCIE
The for oing instrument was acknowledged before me
this day of 11101-a4 20f'i by
BRIAN J MALONEY
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
I! ,d a4ze,�
(Signature of Notary Public -State colorida )
Commission No.2 (Seal)
REVIEW