HomeMy WebLinkAboutBUILDING PERMIT APPLICATION c
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1
Date: 2/4/2017 Permit.Number: 1
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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
PROPQSED IMPR01/EMENT LOCATIQ
Address: 3107 Anderson Dr, Fort Pierce FL 34946
Legal Description: SHERATON PLAZA-UNIT FOUR REPLAT LOT 298 (OR 2721-94)
Property Tax ID#: 1432-807-0056-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
�DE�AILEQ DE'tRIPTION E WORK �
Re-Roof
7
Ct; 1STRUCTIQNINFORM'ATIQ(U. .r 4, ,
... _ _
rtiona workto t e e orme under t is permit—c ec all# appy:
❑
HVAC _Gas Tank E]Gas Piping ILII Shutters a Windows/Doors
11 Electric 0 Plumbing Sprinklers ❑Generator Roof
Total Sq. Ft of Construction: 1760 S Ft. of First Floor: 1760
Cost of Construction:$ 5600 Utilities:In Sewer Septic Building Height:
O11tilNER/LESS r ' CONTRACTC7R
Name Ronald Howard Name: Roderick Waller
Address:3107 Anderson St Company: Sunrise City CHDO, Inc.
City: Fort Pierce State:FL Address: 3550 Okeechobee Rd
Zip Code: 3/4946 Fax: City: Fort Pierce State:FL
Phone NoAOR 7 r Zip Code: 34947 Fax: 772-907-0420
E-Mail: Phone No. 772-201-2850
Fill in fee simple Title Holder on next page(if different E-Mail: rodwallerl@gmaii.com
from the Owner listed above) State or County License: CCC1327208
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SllPPLE,IVIENTAL CONST UCTION LIED LA'U1J IN {7RMATIC}�f
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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 Own r/Lessee/Agent Signat re of Cont actor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF }���_ COUNTY OF \_, C .4 (?
The for ing instr nt as acknowledged efore me The for ing instrum was acknowledg efore me
this day of 20�6y this _ ay of 20 �by
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(Name of person acknowledging) (Na e of person acknowle ging)
(Signature of N t ry Public-State of Florida) (Signatu t r Public-State of Florida)
�Y�K 011� a ion
en R Produced Identification ersona °aIcype Type of I i ' +' i P 13 P • HUFF
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oti����foa�,- ANGELA M HUFF '� Commission# e o1 Florlda
.�: Notary Public-StatrA�{►prlda ��` `���`
Commissio ' 8. _ Commi on I�`r ,��� My Comm.E 'res FFy 27 a9)
= ommtssiPnres May 27 3t) n e throughNationalNotaryq�� ,
My Comm.Ex
on,,"-d through
National P nt,ry Assn ;
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Revised 07/15/M14
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