HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/2/16 Permit Number:,
RECEW-H I'M f52016
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 - ezl�'�,,,
PROPOSED IMPROVEMENT LOCATION: "
Address: 1706 PONDBERRY LANE
Legal Description: LAKE LUCIE ESTATES PLAT 1
Property Tax ID#: 3426-703-0155-000-6 Lot No.141
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTN O'F
IO `WORK:
TEAR OFF EXISTING ROOF. INSTALL NEW TAMKO SHINGLES AND PEEL N STICK
UNDERLAYMENT
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CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit—check all appy:
HVAC Gas Tank Gas Piping Shutters Windows/Doors
11 Electric 0 Plumbing ❑Sprinklers E]Generator Roof
Total Sq. Ft of Construction: 2783 Sq. Ft.of First Floor:
Cost of Construction:$ 10,000.00 Utilities:Sewer O Septic Building Height: 1
OWNER/LESSEE: , ;CONTRACTOR:,
Name JAMES&NANCY ROSS Name: BRIAN J MALONEY
Address:1706 PONDBERRY LANE Company: TREASURE COAST ROOFING
City: PORT ST LUCIE State:FL Address: 1816 SW BILTMORE
Zip Code: 34952 Fax:N/A City: PORT ST LUCIE State:FL
Phone No.772-342-1084 Zip Code: 34984 Fax: 772-343-8358
E-Mail:NSA 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.
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_Signature of ner L see/Agent Signature o Co (tr for i nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF I_ Gi f__ COUNTY OF Lvkc: e
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this N day of /Q0 _J 20 bby this Iq day of , A)C)U 20 1(O by
(Name of person knowledging) (NamWpe n a knowledging)
G
(Signatu o No Public-State of Florida) (Si ature cootary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identificatio Produced r;�1saae�fiit�;�
>>� jE��T BRUf''E�r� T BR(jN :���.�
Commission No. ZZ ae�� Qias'o° y�F� Commission No. `� ,y° F �d�
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12,
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DATE
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INITIALS