HomeMy WebLinkAboutBuilding Permit Application y
J
t
Y ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 2�.
Date: Permit Number: OU ' O�JIJ
- 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
I ROA SSE10 I'0'VEM1=
1. ^y3T
i Address: 5608 Winter Garden Pkwy Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK-UNIT 11-BLK 152 N40 Ft OF LOT 5 AND ALL LOT 8
(MAP 13/12N)(OR 1991-304;2058-1499:2644-810)
Property Tax ID#: 1301-613-0351-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
b. ANi 01 EVA
LEC� MRIF
PI IE WC�RI�� x + ti �
Re-Roof Tear of old roof install new roof shingles
a 111 8r arsaFy z�
�
Additional worrztoa nertormed under this permit-check W all mat appy:
HVAC Gas Tank Gas Piping _Shutters O Windows/Doors
Electric 0 Plumbing Sprinklers Generator W1 Roof 412 Roof pitch
;Total Sq. Ft of Construction: 1903 4,525 S . Ft.of First Floor: 1903
,Cost of Construction:$ Utilities: _Sewer O Septic Building Height:
x +w 1
r
Name Raymond D Morris Name: Roderick Waller
Address:5608 Winter Garden Pkwy Company: Sunrise City CHDO Inc.
City: Fort Pierce State:FL Address: 1209 S Indian River Dr
Zip Code: 34951 Fax: City: Fort Pierce State:FL
Phone No. Zip Code: 34950 Fax: 772-907-0420
I E-Mail: Phone No. 772-201-2850
Fill in fee simple Title Holder on next page(if different E-Mail: rodwaller1@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.
r,
� .e
'FAL lUIAI,COD'S' OCT1d�V LINA�A1N �
"�.+?.� .. ,.k. ''� ,. N r2 r,,. �, �, ..,, � . � s�'»r y°.?? ;� ., .,4:_ �avf an «�"` k ww k � z'•7: 'x.a,.� £..
DESIGNER/ENGINEER: Q Not Applicable MORTGAGE COMPANY: Q Not Applicable
N am e:Raymond D Morris Name:
Address:5608 Winter Garden Pkwy Fort Pierce,FL 34951 Address: 5608 Winter Garden Pkwy
City: Fort Pierce State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: 0 Not Applicable BONDING COMPANY: ✓ LNot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
j 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 thepermit 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 inspectionAf you intend to obtain financing, consult with lender or an attorney before
commeriping work or recording ur otice of Commencement.
Signature of OwnerA Lessee/Contractor as Agent for Owner Signature If ontractor/License 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 4th day of June 20 18 by this 4th day of June 20 18 by
Roderick Waller Roderick Wailer
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
Produ d Pro ced
(S' nat re of Notary Public State of Florida) ( ignature of Notary Publig State of Florida)
Commission No: (Seal) Commission No. LASH.(&$I)IGRAM
v>
a iVotary Public-State of Florida
will, LASHAHNA INGRAM qt= r Leh = ^fiy Co n r �x^i•��i;.-r•Zv �OiB
aY n� �,, ❑„hlir ,tate of Florida ty
= ° My Co•nm c
REVIEWS FRONT 1 ZONING SUPERVISOR �I PLANS VEGETATION SEA TURTLE MANGROE
COUNTER` 'REVIEW REVIEW S'PREVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17