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Date: Permit Number:
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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:
Address: 10725 S Ocean Dr Unit 273 Jensen Beach,FL 34957
Legal Description:Holiday Out At St Lucie BLK D LOT16 AndEqual Pro-Rata Interest In Common Elements (OR 2916,2890,
2888,2891,2892)
Property Tax ID#: 4511-501-0133-000-0 Lot No. 16
Site Plan Name: f Block No. D
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove existing shingle roof and install 5V Mill Finish Metal Roof
3/12- �y
CONSTRUCTION INFORMATION:
Additional work toa orme under tis permit—c ec a . apply:
®HVAC E]GasTank OGasPiping _ShuttersWindows/Doors
®Electric ®Plum bingSprinklers ElGenerator a Roof
Total Sq.Ft of Construction: 1,642 Sq.Ft.of First Floor:_
Cost of Construction:$ 9,100.00 Utilities:E]Sewer®Septic Building Height:
OWNER/LESSE€ . COR4TRACi-OR
Name Norman and Ruth Anderson Name: Ronald Latta
Address:10725 S Ocean DR LOT 273 Company: Treasure Coast Concepts Inc
City: Jensen Beach State: FL Address: 3458 SW Pluto St
Zip Code: 34957 Fax: City: Port Saint Lucie-, State:FI-
Phone No. 772-229-9292 Zip Code: 34953 Fax:772-905-4910
E-Mail: Phone No. 772-777-8130
Fill in fee simple Title Holder on neat page(if different E-Mail: tcconcepts@aol.com
from the Owner listed above) State or County License: CCC1330362
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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