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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED e� Date: 7 J' %g Permit Number: Mvy-ol SCANNED BY �� • _ St. Lucie County Building Permit Application APR 5 2019 Planning and Development Services Building and Code Regulation Division Permitting Department 2300 Virginia Avenue, Fort Pierce FL 34982 t • L c i e County, FL Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial_ R PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III PROPOSED IMPROVEMENT LOCATION: Address: %SO Sw Pic-o5a ZLud Legal Description: �R;WQ-- fPC—PCtin 01 r', T� LaC Property Tax ID #: 34 [C'I •- S-ys ckD 63 - 00 0 - O Lot No. 25' Site Plan Name: Block No. 613— Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: o-C vaL.istfn3 '?,00•F mdel Hof CL+d Uncl¢��csym tn{• CONSTRUCTIONINFORMATION: Aaditional work to I1HVAC e e orme un ert ispermit-check Gas Tank E]GasPiping all apply: ❑Windows/Doors _Shutters E]Electric Plumbing Sprinklers Generator © Roof S /a Roof pitch Total Sq. Ft of Construction: (�' �d S Ft. of First Floor: Cost of Construction: $ 11 a, A0 5 Utilities Sewer ElSeptic Building Height: OWNER/LESSEE: CONTRACTOR: Name 'Zone'la Name: VICq mck In Address: J 7y A/gvctn� a t►y t,. Company: TREASURE COAST ROOFI G city: a—y 4- 4. Lu c i o.r State: E4 Zip Code: '34S 8 3 Fax: Phone No. Address: 1816 SW BILTMORE STREET City: ��51 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: utSR;NtR/MUINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable Name: Address: 1616 SW BILTMORE STREET City: Zip: Phone: Address: Zip: Pho 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. Signature Owner/daee%G- - " ctor-'a'sAgEin-06downer Sig`natufe' - tra`ct6f/ 'C -' e'�Hold STATE OF FLORIDA STATE OF FLORIDA COUNTY OF sTLcum COUNTY OF STLucIE The for ing instru nt w s acknowledge before me The for oing instrum�rnt was acknowledged before me this?dayofT�ri I thisdayofp�.! 20� by 20/ 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 (Signature of Notary Public- StaA of Florida) (Signature of Notary State otflorida ) Commission No. 7 � ynPublic- ission No. (Seal) •K Notary Public State of FI t; "de ?� Victor G Altedzto c • My Commission GG 274 92 REVIEWS FRONT aw rtes 20 2 S VEGETATION V1ct0 GA-lt-e.du`�7p�-- on LVYC rrI)4/ary(�u`lu&'.Y4282 COUNTER REVIEW REVIEW REVIEW REVIEW ExPf aft CCVT DATE RECEIVED DATE COMPLETED Rev.8/2/17