HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: IQ 'lJ�'tlJ
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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
PRL7POSED fIVIPROUEMEIT LO:CATI,ON', " G � u a r
Address: 2897 HARSON WAY, Fort Pierce FL
LLegal Description: SAN LUCIE PLAZA S/D-UNIT ONE-BLK 60 N 20 FT LOT 12
Property Tax_,[D#: 1428-702-1361-000-7 Lot No.
Site Plan Name: Block No.
Project Name:
- Setbacks Front Back: Right Side: Left Side:
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DETAILED PEON-
Re-Roof
TION Re-Roof Tear off old shingle and install new shingles. Detached Garage
CONSTRUCTION IN`FORMATIO`N
_ <. � _ , `:s ,�, � Ta, � �z•'�, Aan.w, r�a�A.0&t
Additional work-to be nertormed uner this permit—check a appy:
HVAC Gas Tank E]Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers E Generator 7 Roof 412 Roof pitch
Total Sq. Ft of Construction: 2450 Sq. Ft.of First Floor: 2450
Cost of Construction:$ 1500.00 Utilities: Sewer 0Septic Building Height:
OWNER/LESSEfrE * 4 #� CONTRACTOR.. .'`
5 . o.
Name Angel L Morris Name: Roderick Waller
Address:2897 HARSON WAY Company: Sunrise City CHDO Inc.
City: Fort Pierce State:FL ,Address: 3550 Okeechobee Rd
Zip Code: 34950 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 CONSTRIJCTI'ON LIEN LAW IN3FORMATION° � x a
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DESIGNER/ENGINEER. Not Applicable MORTGAGE COMPANY: Q Not Applicable
N a m e:Angel L Morris Name:
Address:2897 HARSON WAY,Fort Pierce FL Address: 2897 HARSON WAY
City: Fort Pierce State: City: State:
Zip: Phone Zip: Phone:
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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.
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.
I I n consideration of the granting of this requested permit, I do hereby agree that I will,in all respects,perform the work
lin 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
cornmexcing work or recording our Notice of Commencement.
WfA
Signature of Ow er/Lessee/Contractor as Agent or wner Signature ontr Ar/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 24th day of May 20 18 by this 24th day of May 20 18 by
Roderick Waller Roderick Waller
Name of person making statement Name of person making statement
I Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature o o rg Ptih - mte of Florida (Signature ol Notary Public-State of Florida)
i Commission No. - � = SOPHI HARRIS Commission N ,
,� NIMISfON a FF997093 —$OHIA HA
EXPIRF,S May 30,2020 =' �J{yA�� MY COMMISSION#FF997093
(40))398-0153 r-kgdallotarySemae.00m J'r f�
May 30.1091
401)398-0153 1oridallotarySenirce.corn
REVIEWS FRONT ZONING SUPERVISOR PLANS GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17