HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE 1INFO (MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q
Date. �d 1 ��5 Permit Number:
_• __ RECEI`,`D AUG 152016
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 ® ks
PROPOSED IMPROVEMENT LOCATION.'
Address: 3503 AVE P FORT PIERCE,FL
Legal Description: LOT W 1/2 OF 2 AND ALL OF 3 BILK 19
Property Tax ID#: 2405-601-0344-000-7 Lot No.2&3
Site Plan Name: Block No. 19
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAI''LED DESCRIPTION'OFWORK:
TEAR OFF EXISTING ROOF. INSTALL NEW TAMKO SHINGLE ROOF WITH w s Z lC
UNDERLAYMENT �«I
CONSTRUCTION,INFORMATION:
Additional work to e e orme under is permit—c ec a appy:
HVAC f]Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
U Electric 0 Plumbing Sprinklers LI Generator Roof
Total Sq. Ft of Construction: 2044 Sq. Ft.of First-Floor:
Cost of Construction:$ 10,000.00 Utilities: Sewer E]Septic Building Height: 1
-OWNER/LESSEE: �CONTRACTOR: .
Name THOMAS BUSH Name: BRIAN J MALONEY
Address:3503 AVE P Company: TREASURE COAST ROOFING
City: FORT PIERCE State:FL Address: 1816 SW BILTMORE
Zip Code: 34947 Fax:N/A City: PORT ST LUCIE State:FL
Phone No.772-468-6232 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 LIEN ,LAW.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.
/' v
I —I— — J _5�9_ S
_Signature of Own Les z9gent Signature of—Cont r cr Li&pee Holder
STATE OF FLORI ASTATE OF FLORIDA
COUNTY OF LuC.1 C COUNTY OF Sk LUI C'k f
The forgoing instr ent was a knowledged before me The forgoing instru ent was acknowledged before me
this a— day of h 20 JLby this a day of 20 t 6 by
YMCA V
(Name of person kn ledging) (Name of per on acknowledging)
(Signaturrot
Public-State of Florida) (Sig ur otary Public-State of Florida)
PersonallyKnown OR Produced Identification Personally Known OR Produced Identification
Y
Type of Identificati Produced Type of Identificati Produced
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Commission No. .... RRT UN Commission No.
12,• Gpt�N11SS/pN•.��iii
Revised 07/15/2014CD
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