HomeMy WebLinkAboutBuilding Permit Application Y ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 120/- (�
Date: Permit Number: oca9
e s
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
Address: 6604 Ocala AVE Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK-UNIT 10-BLK 133 LOT 11 (MAP 13/01 S)(71-86CP)(OR 654-2287:3655-1678:4127-103)
'Property Tax ID'#: 1301-612-0353-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
-
O711� OD��CRIPT100 WORK � � ss ak
Re-Roof Tear of old roof install new roof shingles
�ONSTRUCT(ON INFORMATIONsaf, �
x&JJkY.S
ax „�:v r.>_e,M
Additional work to be nertormed under this permit—check a appy:
E1HVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors
0 Electric 0 Plumbing Sprinklers Generator Roof 5/12 Roof pitch
Total Sq. Ft of Construction: 1512 S . Ft.of First Floor: 1512
Cost of Construction:$ 6,525 Utilities:cn Sewer 0 Septic Building Height:
VVNER/L� 5EARNN
. . _.. ,C NTRACT71 F , r ,�
-__ �,r__ .
Name Bryan L Vozar Name: Roderick Waller
Address:6604 Ocala AVE 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
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.
P
S IPPLEMENTA CQNSTFtUCTIrON L N IAW INFORM" TiC?N
.z.a > i�
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Q Not Applicable
Name:Bryan LVozar Name:
Address:6604 Ocala AVE Fort Pierce,FL 34951 Address: 6604 Ocala AVE
City: Fort Pierce State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Q 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 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 inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signat&0'4110wner Lessee/Contractor as Agent for Owner Signature o Co tractor/Lic se Holder
STATE OF FLORI A 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 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
na ure of Notary Public-Stat of Florida) (Signature of Notary Public-Stake of Florida)
Commission No.h LASHA(Seal)IGRAM Commission No. (Seal)
tin.
: x` Notary Public-State of Florida
ires Dec 20,20 ' � _
:. My Comm.Exp
n �E 724r' ,,`�tPRY�'b���� LASHAHNA I G n
'%'9rE moo;, ""^n1^ :r u = Abtary Public-Sate of Florida f
Or ,` o d t rau h Natio,al tiota" ,
REVIEWS. FRCS � ( IN S'(TPERVISOR PLANS VEG A ,"� SE'Al9RTLE�ires GNJANGfjQVE
C UT REVIEW REVIEW REVIEW REV1REVPEW'ion# =F 1RE_U,IEW
i
DATE eaw,al Notary:r ..:::_. Assr
RECEIVED
DATE
COMPLETED
Rev.8/2/17