HomeMy WebLinkAboutBUILDING PERMIT APPLICATION_M
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �. SPermit Number:
l90 v of �a
-6zaj-- F
RECEIVED
Building Permit Applicati n APR 5
Planning and Development Services 2019
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial R�'id&Mftl' b Cow FL
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
PROPOSED IMPROVEMENT LOCATION:
�M;� UPI •
Legal Description:
PropertyTaxlD#: Lot No. _ C.
Site Plan Name: Block No. �XQ
Proiect Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Tyr 0- ex154.11r\9 reo4 owL8 41AVA SV rme cJ I�of a,n.a
O'f 'PI-M 1ZDgti,� I ns� qll r\w., ► VNN
CONSTRUCTION INFORMATION: III
I—jHVAC L=1 Gas Tank UGas Piping
11 Electric 0 Plumbing Sprinklers
Shutters
Generator
Total Sq. Ft of Construction: ci 6 S 6 SQ �Ft. of First Floor:
Cost of Construction: $ I $, 3C7 O Utilities. L Sewer Septic
Windows/Doors
RRoof S %a Roof pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name �A \ _
Name: or
Address: J -1.0 q �1R �� Q 0.� C �O�
Company: TREASURE COAST ROOFING
City: 31gdu, State: EL-
Zip Code: Sj j et S L Fax:
Phone No: `��- �I,6�
Address: t 816 SW BILT9MORE STREET
City:�O -- LV C 1. 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 Owrier 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: late 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 vour Notice of Commencement.
Signatur Owner/ Less /Conti y as Agent for Owner
STATE OF FLORIDA
COUNTY OF ST LcuiE
The forgoing instrum�ef t was acknowledged before me
this�day of / �Glydh 20L4 by
BRIAN J MALONEY
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Signature of Comractorjljeftse
STATE OF FLORIDA
COUNTY OF STLecIE
The forgoing instrument was acknowledged before me
this dayof!(j✓-; 20JIby
BRIAN J MALONEY
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
��La "� / a44�
(Signature of Notary Public- Stap of Florida) (Signature of Notary Public- State of Orida )
Commission No. %1-4? fA
(Seal
mmission No.a, ,2? 212_
(Seal)
�,�ay hyk
Notary Public State of PloliOa
Victor G Alta zio
.ray by
Notary Public
Alb
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Rev. 8/2/17