HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: ,2 - $ ( � Permit Number: I r
AIR RECEIVED
Building Permit Application FEB 2 9 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
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: 6611 Fort Pierce Blvd, Fort Pierce FL
Legal Description: LAKEWOOD PARK-UNIT 7- BLK 77 LOT12(MAP 13/02N)(OR 3598-1156; 3834-1544)
Property Tax ID#: 1301-607-0196-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove and Replace 33 sq Shingles
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy:
HVAC Ei Gas Tank []Gas Piping M
Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator 7 Roof 412 Roof pitch
Total Sq. Ft of Construction: 1943 SFt. of First Floor: 1943
Cost of Construction: $ 4,500 Utilities:n Sewer 11 Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name Ghazanfar Saeed Name: Roderick Waller
Address:5201 Paleo Pines CIR Company: Sunrise City CHDO Inc.
City: Fort Pierce State:FL Address: 3550 Okeechobee Rd
Zip Code: 34951 Fax: City: Fort Pierce State.FL
Phone No. 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@gmail.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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ✓Q Not Applicable MORTGAGE COMPANY: a.Not Applicable
Name:Ghazanfar Saeed Name:
Address:6611 Fort Pierce Blvd,Fort Pierce FL Address: 5201 Paleo Pines CIR
City: Fort Pierce State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: 0 Not Applicable BONDING COMPANY: allot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 Owner/Lessed/Contractor as Agent for Owner Signature of Contractor/Lic6nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucie County COUNTY OF St Lucie County
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 28th day of February 20 18 by this 28th day of February 20 18 by
Roderick Waller Roderick Waller
Name of person making statement Name of person making statement
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Not ry Public-State of Florida ) (Signature o71' -State of Florida)
Commissi t0y5}: SOPHIA HARM) CommissionSOPHIA H�ib
'c MY COMMISSION#FF997093 ISSION#FFEXPIRES May 30,2020EXPI 997093
p,��,` RES May 30,2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MA GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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Rev. 8/2/17