HomeMy WebLinkAboutBUIDLING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE A C
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Date: Permit Number: V\_/
SCANNED
BY RECEIVED
St. Lucie County
Building Permit Application AIJ6 14 2020
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 st, Lucie county
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:---7.9-00 U-S _Piq�WOLQ
I
Legal Description:
Property Tax lD#: Aqlq— Sof — 1-7D( — 000-: 9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: _ Right Side: Left Side:
DETAI LED DESCRI PTION OF WORK:
cii,cl 111S4011, Y"XA_J GV yl-�+C�,(
I CONSTRUCTION INFORMATION: I
MUUILIUIIOI WIJI A LIJ IJU Ul IV[ IIIUU UllUel MIS permiE — cneCK all apply:
ElGas Tank E]Gas Piping In Shutters Windows/Doors
11 Electric Plumbing []Sprinklers Elenerator E� Roof B)u Roof pitch
Total Sq. Ft of Construction: igg Sq. Ft. of First Floor:
Cost of Construction: $ o(.� Utilities: []SewerE]Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name'liO4%J Y\ t�ui
11ACt
Nam;7�v-;C-n
Wbrx—Ar
Address:' ' 70C)t) ':>. uS.
'JtAwg I
company: TREASURE COAST ROOFING
cityr
a�)c4 .5,L. I vc-;-.P-
, d e..,3
Zip Code -3 q 9,S a Fax:
Phone No.— Qo)—
staie:5!L
Address: 1816 SW BILTMORE STREET
City: C) Y � 154 - i state: FIL
Zip Code: �341064 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 at construction is 52500 or more, a RECORDED Notice of Commencement is required.
Ah
F_ 11
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORIVIATIONs
11 v �
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone—
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: —Not Applicable
Name:
Add * ress: 1816 SW BILTMORE STREET
Address:
city:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby madeto 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 Court makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in con%ct with any applicable Home Owners Association rules, bylaws or ang 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.
Sigrr4lai,ca.,dfOvm!�1�6 ctor as Agent for Owner
Signore:!r'f—C�ractor/Lice e Hol
STATE OF FLORIDA
STATE OF FLORIDA
COUNTYOFST LCUIE
COUNTY OFSTLUCIE
The f��g instrumMit was acknowledg%6before me
this/ ,:;p ay of 20/7 by
_"l—
The Ing ins e
f2r.7 trumqnt was acknowledg.4before me
this — day of in" 20 by
t
BRIAN J MALONEY
BRAN 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- State cGloricla I
(Signature of Notary Public- State ffFlorida I
Commission No. C-drj-7 Qk2.,
mmission NoAw-974:21�1-(Seal)
Notary Public State of Florida
=Nlt,ly,f Monde
P-bl. state
Victor G Alterizio
Victor GAItenzio
U rn—,kqion rr 77A292
Expiref 11/05/2022
REVIEWS FRONT %20WWQVN6
COUNTER REVIEW REVIEW
V
g Notary Public State of Monde
ANS
V1
REVII EW
VEGET
REVI�E
Victor GAlten"o
on
JEN 512c
%
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17