HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number: D
BY
St. Lucie Couni9p RECEIVED
Building Permit Application MAR 2 8.2019.
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: Roof
PROPOSED IMPROVEMENT LOCATION: _
Address: _ Z'8'I ' Sai'A Hark-og
Legal Description:5� -NArne,s riJny k
Property Tax ID M a'43e-) - Sal — ng�ZO —"A Lot No. f
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIONOFWORK:
Tom- a4 �� ii�5 ro�� i>ns�a�l,`ng new Sv�al o.
CONSTRUCTION INFORMATION:
Additional wor to De ertormed under tis permit — cneck all Inat appil
11HVAC Gas Tank []Gas Piping 11 Shutters ❑Windows/�Doors
11 Electric Plumbing Sprinklers C Generator Roof � Roof pitch
Total Sq. Ft of Construction: '4 Z1 G S Ft. of First Floor:
Cost of Construction: $ 11I L1 d o Utilities: Sewer 0Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name an A 1 �. i
Name: G
h
Address: p�
Company: TREASURE COAST ROO ING
City: Oro- 'PiQJCar State: FL
Zip Code:3C{9 ba Fax:
Phone No. 1Q — a 06 — ISQ b
Address: 1816SWBILTMORESTREET
CityDv-)— <,N,. Lu6q, 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: 1876 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
Signature of Owner/ Lps4e/Co V96as Agent for Owner
Signature ontractor Li nse r
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST LCUIE
COUNTY OF STLucie
The forgoing instrumen was acknowledged j�efore me
this�dayof. 20)9 by
The forgoing instrum�9t was cknowledged efore me
this "day of /`! 20LJ 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
� !/
� 2 4�
(Signature of Notary Public- State of Floy da )
(Signature of Notary Public -State of Prorida)
Commission No. _&g-74i (Seal)
Commission No .?7 o29Z• (Seal)
d'2be.Notary Public State of Plod
c My C
mmission GG 2742G
Notary Public
tote of Florida
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DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17