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ALL APPLICABLE INFO MUST BE COMPLETED:FOR APPLICATION TO BE ACCEPTED !�� G
Date: PermitNumber:
-- Building Permit Applicati®n
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone:(772)462-1553 Fax:(772)462-2578 Commercial Residential X
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PERMIT APPLICATION FOR: Roof
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PROPOSED IMPROVEMENT LOCATION:
Address: 10725 S Ocean Dr.Unit 16Jensen Beach,FL.34957
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Legal Description: Holiday Out at St Lucie BLK C LOT 16 and Equal Pro-Rata Interest In Common Elements(OR 1535-1871
;3106-248)
Property Tax Io#: 4511-501-0103-000-1 Lot No. 16
Site.Plan Name: Block No.- C
Project Name:
Setbacks Front Back: Right Side: Left Side:
FOETAILED DESCRIPTION OF WORK: i' s
Remove existing shingle roof and install 5V Mill Finish Metal Root �
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CONSTRUCTION.INFORMATION ¢
A ►trona wo to e e arm under tis permit— ec a _appy:
]HVAC 0 Gas Tank Gas Piping hutte
rs Windows/Doors
Electric Q Plumbing OSprinklers Generator 11' l Roof
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Total Sq.Ft of Construction: 2,306 So.Ft.
{of First Floor:
Cost of Construction:S 9,175.00 Utilities:0Sewer 0Septic � Building Height-
OW NERAESSEE,:
eight:COWNERAESSEE: CONTRACTORi-, i
Name Daniel and Polly Salopek Name: Ronald Latta
Address: 10725 S Ocean Dr Lot#275 Company:Treasure Coast Concepts Inc
City: Jensen.Beach State: FL Address:3458 SW Pluto St
Zip Code: 34957 Fax: City: Port Saint Lucie, j State:FL
Phone No. Zip Code:34953 Fax:772-905-4910
E-Mail: Phone No.772-777-8130
Fill in fee simple Title holder on next page(if different E-Mail:tcconcep"aol lcom
from the Owner listed above) State or County Licenser CCC1330362
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If value of construction is.$2500 or more,a RECORDED notice of Commencement is required.
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