HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: b�SCANNED Permit Number:
BY
St. Lucie County
— RECEIVED
Building Permit Application
Planning and Development Services MAY 2 0 2019
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residen la
PER IT APPLICATION FOR: Roof — _Xi f dvT
PROPOSEDCIMPROVEMENT LOCATION:
Address: a30 5E CLtihtino S1-
Legal Description: K I U 4.e Darkyn,J .3
Property Tax ID #: 3<i19 - S I S - O as d a bLot No. 39
Site Plan Name: Block No. ate_
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Tor- of e,xisjilh rJA4 aid 1/1510,U nsw F14 ILoo-r
N INFORMATION:
[1HVAC L-1Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction: 78 (-)
Cost of Construction: $g, 100
Piping _Shutters ❑Windows/Doors
nklers I Generator E Roof N A Roof pitch
Sq. Ft. of First Floor: _
Utilities: Sewer 11Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 7Su4i'n Ue Gleam-
Address:A30 .5E in'anaiao 5%
Name:
Company: TREASURE COAST RO FING
City: 70 SL 6,uGSL State:
Zip Code3ygsa Fax:
Phone No. 90 q - -70q :2 I S
Address: 1816 SW BILTMORE STREET
City: > State: FL
Zip Cohe: 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
it value of construction is 92500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address: 1818 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.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST LcuiE
COUNTY OF ST LUCIE
The forgoing instrument was acknowledgeA before me
this R& day of M.4 20by
(
The f oing instrume9t was acknowledged before me
this � day of 20-4 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
PPr/rood/duced
Produced
/�/{w]�Q�,
J
1 do/
(Signature of Notary Public-Stat of Florida )
(Signature of Notary Public-Stat f Florida)
Commission Nt�Y� (Seal)
Commission No a?7 i Z (Seal)
NotarY Public State of Floiitla
K, Narypublic Stale of Flo6da
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DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17