HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater ,sem). J Permit Number: ) 10 �
RECEIVE
Building Permit ApplicationDECEQ 21206
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 T
Address: �LL�" C� �C,anc �U� 1` Iee1C4,
Legal Description:.s ay-lo S W Cz Ga t
Property Tax ID#: Zqo 9 - 7!y -O C) O a - C7 C) - Co Lot No. 2
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left.Side:
DETAILED DESC"RI;PTION OF�WORK
TEAR OFF EXISTING ROOF. INSTALL NEWROOF WITH PEEL N STICK
UNDERLAYMENT
CONSTRUCTION INFORMATION
Additional work toe e orme under this permit-check
a apply:
HVAC rl Gas Tank []Gas Piping _Shutters a Windows/Doors
Electric F-1PlumbingSprinklers []Generator Roof
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 15,000 Utilities:Sewer Septic Building Height: 1
OWNER/LESSEE: CONTRACTOR'
Name 1;7e,or Qg' Cif. 4.rhOA w Name: BRIAN J MALONEY
Address: 6 a^( nler',1Acr AVE• Company: TREASURE COAST ROOFING
City: �o�-� N i Q rC2 State:FL Address: 1816 SW BILTMORE
Zip Code: -Sq W J Fax:NIA City: PORT ST LUCIE State:FL
Phone No. Zip Code: 34984 Fax: 772-343-8358
E-Mail:NIA 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.
a
s
_Signature of Owner/ ee/ a Signature of Contractor/ "ce se
1,4
STATE OF FLORIn_a,& STATE OF FLORIDA
COUNTY OF Gam, COUNTY OF� LN&C% -e
The fo oing instrume was acknowledged before me The forgoing instrum t was acknowledged before me
this I day of G 20 �3e by this_Zday of 20l(G�by
Rzamn1M�1 I��io.n I OOJO,-e.�(
(Name of person ledging) (Name of person ack wledging)
(Signatureofff
Public-State of Florida) (Signature ublic-State of Florida)
,,��� ,-:;. ili 11 i/
Personally Known OR Produ5ii�� R i <i Personally Known OR Produced�tv#
Type of Identificatio Produced dv c��.`�S10N fik'°• � Type of Identificatio Produced �c�' ..•_.^•.._•__ o<i�
�a2078 9F` ..*5 f*2
Commission No. a,(�al) iCommission No.gc
7 °•:*
a is' 12249 ? 4W
�.y •. 9
onBondea� e�• v
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
[INITIALS