HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: PermitNumber:
J�' �• I /
RECEIVED
Building Permit Application MAR 0 5 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
1300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 6904 OCALA AVE, Fort Pierce FL
Legal Description: LAKEWOOD PARK-UNIT 10- BLK 129 LOT 6 (MAP 13/01S)(OR 4082-1285)
Property Tax ID#: 1301-612-0254-000-1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove and Replace 26 sq Shingles
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy:
HVAC E] Gas Tank Gas Piping _Shutters ❑Windows/Doors
aElectric ❑ Plumbing Sprinklers Generator Z Roof 712 Roof pitch
Total Sq. Ft of Construction: 1243 S Ft. of First Floor: 1243
Cost of Construction: $ 3,200 Utilities:Sewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Miguel A Guerra-Ressy Name: Roderick Waller
Address:7104 Santa Clara BLVD 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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Q Not Applicable MORTGAGE COMPANY: Q Not Applicable
Name:Miguel A Guerra-Ressy Name:
Address:6904 OCALA AVE,Fort Pierce FL Address: 7104 Santa Clara BLVD
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
com,
,Mencingwork,or recording our Notice of Commencement.
Sig ature of OwnerlLessee/Contractor as Agent for Owner Signature of Con actoInse 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 5th day of March 20 18 by this 5th day of March 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
Pr ed Produced
(Signat ary PtP a a) (Signature f Y PublirS�t� �
MY COMMISSION#FFg97 93 S
Commi 5 EXPIRES May 30,2l al) Commissio MY COMMISSION#Ff���P3
(101)399-0153 FWd*N0teryS9rv�u.com a�May 30,2020
(101)399.0153 FbriOallotary$srwca.com
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17