HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: P rmit Number: �- l• W��
Building Permit App ication
Planning and Development Services
Building and'Code Regulation Division
1 2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
;PERMIT APPLICATION FOR: Concrete ���
PROPOSED I)VIPROUEMENT L:OCATIO.N::_ T �
Address: 5213 BOWLING GREEN DR, Fort Pierce FL
Legal Description: LAKEWOOD PARK-UNIT 2-BLK 11 LOT14(MAP 13/ 1S)(OR 3914-2311)
Property Tax;ID#: 1301-602-0023-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION QF,UI%ORK
,
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Install New Driveway
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iCONSTRUCTION INFORMATION x P
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Additional work to benertormed under this permit—check ar ply:
HVAC' Gas Tank ❑Gas Piping _St utters l]Windows/Doors
Electric ElPlumbing Sprinklers EIG nerator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: 1567 S . Ft. of First Floor: 1527
1585.00
Cost of Construction:$ Utilities: _Se er Septic Building Height:
i
OWNER/LESSEE '*�`,CONTR CTOR
i Name Cesar Martinez Name: Roderick Waller
Address:2629 S 26th ST Compan : Sunrise City CHDO Inc.
City: Fort Pierce State:FL Address: 130 S Indian River Drive Suite 202
Zip Code: 34981 Fax: City: For: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: r dwaller1 @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�CQNSTItgUCTION L1EN LAW INFORMATI N
DESIGNER/ENGINEER: Not Applicable MORTGA13E COMPANY: Q Not Applicable
N a m e:Cesar Martinez Name:
Address:5213 BOWLING GREEN DR,Fort Pierce FL Address: 2629S26thST
City: FortPierce State: FL City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: EZI Not Applicable BONDINC COMPANY: MNot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtair 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 th t I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St. Luci County Amendments.
The following building permit applications are exempt from undergoing a full c ncurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and ccessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Comment: ment may result in your paying twice for
improvements to your property. A Notice of Commencement mut be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, cons At with lender or an attorney before
commencing work or recording ou Notice of Commencement.
Signature of Owner/L ssee/Contractor as Agent for Owner Signature of Contra for/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 forgoi ig instrument was acknowledged before me
this 16th day of July 20 18 by this 16th clay of July 20 18 by
I
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 Id ntification
Prod u ed Produ
(Signature of Notary Public-State of Florida) (S itfnatur of—N* agl
< SOPHIA HARRIS
Commissi n, k*►.zSOPHIA HAq ) Commissi n N .; - my COMMISSIof� 1g709S
=•• '_ MY COMMISSION#FF997093 '';fif`4;,�� EXPIRES May 30,2020
S. EXPIRES May 30.2020 14bgt��g i$3__ - ,F(arirtsNota
•ri.� - - rYserme.com
(407) 98-0153 FloriC Notarye
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17