HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: w. 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: 49 SAN LUIS OBISPO
Legal Description: SPANISH LAKES COUNTRY CLU
Property Tax ID#: 1301-111-0001-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
TEAR OFF EXISTING ROOF. INSTALL NEW 5 V METAL ROOF WITH PEEL N STICK
UNDERLAYMENT
CONSTRUCTION INFORMATION:
Additional work toe e Orme under this permit—check a that appy:
HVAC 11 Gas Tank ElGas Piping _Shutters Windows/Doors
11 Electric 0 Plumbing ❑Sprinklers Generator Roof
Total Sq. Ft of Construction: 1500 Sq. Ft.of First Floor:
Cost of Construction:$ 8350.00 Utilities: 0Sewer Septic Building Height: 1
OWNER/LESSEE:, CONTRACTOR:
Name INGRID S JOHNSON Name: BRIAN J MALONEY
Address:49 SAN LUIS OBISPO Company: TREASURE COAST ROOFING
City: FORT PIERCE State:FL Address: 1816 SW BILTMORE
Zip Code: 34951 Fax:NSA City: PORT ST LUCIE State:FL
Phone No. 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 the permit 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 Ow r/L sseAgent Signature of C ac icense Holder
STATE OF FLOTbAC�e_
STATE OF FLORIDA
COUNTYOF COUNTY OF SSL t%,&de
The forgoing instrumerjtwas acknowledged before me The forgoing instrurnNt was acknowledged before me
this I day of 20 J(,Jby this , day of .20 by
r�Ur J VMCA6 r�Z
(Name of person no ledging) (Name of pets a knowledging)
(Signatur 1\14APublic-State of Florida) (SignarAlotary Public-State of Florida)
Personally Known OR Produced Identifkq� iq Personally Known R roduced I� tlf) irlblb��,r
Type of Identificatio Produced ����,', T B Type of Identification/Produocedp
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Commission No. ��.Se�}��o ay 12,2p -fo°• Commission No.
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DATE
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INITIALS