HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ( e���-� Permit Number: /(o lel- "560
isRECEIVED
Building Permit Application DEC 21 2016
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 IM;PROVEMENT LOCATION: `
Address: a50(( iSa(a 6eAla Dr.
Legal Description: 2%6& �+�// y� i=ra,,� N� c a�' SQc 9a run S of 1Dea_�_y6 Mew OG mr-
W \qC� d3 F4 �o C1L n4 iSolG+ &//q Dr.
Property Tax ID#: ay-19- -'/4/`{- W is-vao -V 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 ROOF WITH PEEL N STICK
UNDERLAYMENT
CONSTRUCTION INFORMATION
Additional work toe e orme under this permit-check a appy:
HVAC 1,Gas Tank ❑Gas PipingShutters Q Windows/Doors
11 Electric El Plumbing ❑ _Sprinklers �Generator Roof
Total Sq.Ft of Construction: tai.�� 0 S . Ft.of First Floor:
Cost of Construction:$ / CI 0 o 00 Utilities:11 Sewer Septic Building Height: 1
OWNER/LESSEE CONTRACTOR:
Name &qcin k. uw,51e, Name: BRIAN J MALONEY
Address: �SIsDq Company: TREASURE COAST ROOFING
City: TDA, Y i Q cz State:FIL Address: 1816 SW BILTMORE
Zip Code: 349511 Fax:N/A City: PORT ST LUCIE State:FL
Phone No. 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 INFORMATIOWp.
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.
.,r
27-1
S
_Signature of Own ess gent Signatur of ontr r/Li s Ider
STATE OF FLORIDA STATE OF FLORIDA.
COUNTY OF - CI)C_ COUNTY OF bac.'
Thejprgoing instru t was acknowledged before me The foing instrument4vas acknowledged before me
this day of 20y this Z.Plday of 20 16 by
►-a rl G s�-t
(Name of person ac w dging) (Name of person o dging)
(Signature o a ub c-State of Florida) (Signatu of otary Public-State of Florida)
Personally Known_VO OR Produced Identification Personally Known)—OR Produced Identification
Type of Identification—Produced Type of Identification Produced
�ae4laaaiHlHOEgesr/ a a11i11iPs�e�
Commission No. ,q��� �N/(F /�i°'ter Commission No. \e� ,RUNI(F
`hQv�°NQ,,S10 DFI o�•,• o ate\p��•\5S10N EXpj••, o���e
e 0, ZP*
Revised 07/15/2014 0 •� - e
is° ®12234 °�� e •G �4434 °�=
2
•%'6'•• 6� �o �,• sis-.
REVIEWS FRONT ZO :�;!°�R) �ISOR PLANS VEGETATION SEA T6 14 W6 PUBLi S 'Y•°• ..
COUNTER REVIEWEW REVIEW REVIEW REVIi,� �u LIG
DATE
COMPLETE
INITIALS