HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/1/15 Permit Number: f
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PROPOSED IMI?ROVEMEN,T LOCATION `„ T
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Address: So C/l2 e j' ,f1vP I-',e rc C
Legal Description:
Property Tax ID##: 3yld- 2-dwa-6-oy_0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED D
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IPT t �
CR IOOF WORK E "
CONSTRUCTION�INFORMATI,ON
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Additional work to be Deffco-rmed under this permit-cleck On appy:
11HVAC Gas Tank E]Gas Piping _Shutters Q Windows/Doors
Electric Plumbing Sprinklers E Generator Lk_JRoof
Total Sq. Ft of Construction: 2 dK Sq. Ft.of First Floor: tag
Cost of Construction:$ 1O,.S� Utilities:Sewer E]Septic Building Height:
Name'L✓We G e s Name: ,'ars ALI&i e
Address: '50W 61ea e- Company: 7rea,rufe
City: Fog P"e'c-e Stater Address: I$1G _r ✓ 81
/fa�or
Zip Code: 3Iq Ya Fax: City: �' Se'r'W-LVe-"C State: FL
Phone No. 77.2-71(-g6'uZ Zip Code: 3/981-1 Fax: 7702-3y3`93fff
E-Mail: Phone No. 77-2-370 -Q770
Fill in fee simple Title Holder on next page(if different E-Mail: l'C 14-f' LL c(o 5rna%l,c6.n
from the Owner listed above) State or County License: CcC /33 de/5
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION URMATION ,
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 our Notice of Commencement.
S
_Signature of Ow / see/Agent Signature oT—Cor995Alicense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF j- Lttc.r COUNTY OF STLUCIE
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this dayof—M4X 20 Irby this_�_day of 20 15 by
BRIAN MALONEY
(Name of person ackn ledging) (Name of persona wledging)
(Signature ofo a u ic-State of Florida) (Signa re of N Public-State of Florida)
PersonallyKnown OR Produced Identification Personally Known OR Produced Identification
Y
Type of Identificati Produced Type of Identificat' n Produced
Commission No. (Seal) Commission No. 2 Z � (Seal)
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Revised 07/15/2014 `\� o�Mis2 % `\ :y�'°ay ls2/OtiF
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REVIEWS FRONT ZONI '• sEF3ljMVISCl � PLANS VEGETATION SEATURTL��%J1. 1� FC /EyCOUNTER REVIE9W:o� REVIEW REVIEW REVIEW � s :'
COMPLETE DATE /�'f�����sTATE�`�\���\\ /�����i!TAT 0,\�\X
INITIALS