HomeMy WebLinkAboutBuilding Permit Application • •
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9125118 Permit Number: 1061--- 0579
COCI.INTY
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: Other
PROPOSED IMPROVEMENT LOCATION
Address: 7302 LAKELAND BLVD, Fort Pierce, FL 34982
Legal Description: ORANGE BLOSSOM EST-SECOND ADDN BLK 4 LOT 6 (0.19 AC)(OR 1420-2387)
Property Tax ID#: 1301-607-0014-000-1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side:_ Left Side:
DETAILED DESCRIPTION , F WORK �"4
..
Install Garage door
CONSTRUCTION N FOR MATION
Additional work to be performed under this permit—check allhat apply:
HVAC _Gas Tank Gas Piping � _Shutters I I Windows/Doors
Electric ❑ Plumbing Sprinklers _Generator _Roof Roof pitch
Total Sq. Ft of Construction: 1746 59,11 of First Fnloor: 1746
Cost of Construction:$ 1,800.00 Utilities:Sewer l !Septic Building Height:
OWN ER/LESSEE °;CONTRACTOR: ,'
Name Gholamreza Torkaman Name: Roderick Waller
Address: Company: Sunrise City CHDO Inc
City: Vero Beach, State:FL Address: 130 S Indian River Drive
Zip Code: 32962 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: rodwaller1@gmail.com
from the Owner listed above) State or County License: CCC1327208 /rj/tj r if'
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 7
A7" •
SUPPLEMEN7 ENTALCONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: Q Not Applicable MORTGAGE COMPANY: ✓Q Not Applicable
Name:GholamrezaTorkaman Name:
Address:7302 LAKELAND BLVD,Fort Pierce,FL 34982 Address:
City: Vero Beach, State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: n Not Applicable BONDING COMPANY: Not 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
commencing work or recording your Notice of Commencement.
gsLk.._10j .
L-x.e"k
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Con Tactor/License Holder
STATE OF FLORIDA` STATE OF FLORIDA
COUNTY OF St Lucie COUNTY OF St Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 25 day of September ,20 18 by this 25 day of September ,20 18 by
Roderick Water Roderick Waller
Name of person making statement Name of person making statement
Personally Known 0 OR Produced Identification Personally Known 151 OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of Florida) (Signature o �Ii.tary Pub ic-State of )
Commission Notary Public Isti(9tigfyida Commission N•. NataryPublic outs(ina l
Harris
% J• My Commission GG 238073 •g • My Commission GO 238873
Expires 05/30/2020 slaw Expires 05/30/2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW,
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17