HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i
Dater Permit Number: 1 D
R E C E 1','7 D IMA'( 2 3 2016
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 IMPROVEMENT LOCATION'
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Address: oL Jam r V`GAC_-T1,0
Legal Description: S rich 1a s CQU�r17�I C�uk
Property Tax I D#: Lot No.
Site Plan Name: Block No_
Project Name:
Setbacks Front Back: Right Side: Left Side:
DLTAI.LED';DESCRIPTION OF WORK
TEAR OFF EXISTING ROOF. INSTALL NEW SqU1111WAL ROOF WITH PEEL N STICK
UNDERLAYMENT g1-►�1.��
CONSTRUCTION INFORMATION:
Additional work toe performed under InGas
permit–c ec a y:appHVAC 11 Gas Tank Piping 1:1_Shutters Q Windows/Doors
11 Electric 0 Plumbing U Sprinklers [Generator Roof
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ ��dD Utilities:Sewer —Septic Building Height: 1
OWNER/LESSEE CONTRACTOR:
Name o f n W Name: BRIAN J MALONEY
Address: 0 WmAsYf Company TREASURE COAST ROOFING
City: State:FL Address: 1816 SW BILTMORE
Zip Code: rI Fax:N/A City: PORT ST LUCIE State:FL
Phone No. T — C166 A S Zip Code: 34984 Fax: 772-343-8358
E-Mail:N/A Phone No. 772-370-9770
Fill in fee simple Title Holder on next page(if different E-Mail: TCROOFINGLLC@GMAIL.COM
from the Owner listed above) State or County License: CCC1330653
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIENIAW INFORMATION:
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 thepermit 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.
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_Signature of Owner/L s e/A Signatu of Contra r/ Gens der
STATE OF FLOR STATE OF LU+`C� COUNTY OFORIt� Lv�C�2
COUNTY OF
The forgoing instrument was acknowledged before me The,f oing instrument was acknowledged before me
this day of I✓M1 20 Y2-by thisar day of 20 1_6 by
(Name of person acknowledging) (Name of person acknowledging)
y��4lSt�!it i,"fi f ff
(Signatuo of N ry blic-State of Florid '�R,.•°... �P<< (Signat ry Public-State of Florida) a
e�Q��•H•,�s 2�oFkA/9°°• mid '/ ��dm�°��a�RTlBRUN�fif,�
Personally Known OR Produced der ion �8 �m: ersonally Known (�OR Produced IdeQ
Type of Identificatio Produced �•,,, gFype of Identification Firoduced
Commission No. H5ea tF�12arc�•&y.°o Commission No. Zel) ®•® �*
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS