HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
s - i = _ _ RECEIVf7-�
Building Permit Application SEP 18
Planning and Development Services
Building and Code Regulation Division ST,MKO�! '' '� 'n9
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 2406 Holiday Ct Fort Pierce, FL 34982
Legal Description: ORANGE BLOSSOM EST-SECOND ADDN BLK 4 LOT 6 (0.19 AC)(OR 1420-2387)
Property Tax ID#: 2421-605-0029-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove and replace Shingles 3/12 Pitch Underlayment FL16048-R6, Shingles FLFL10124
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy:
HVAC Ei Gas Tank []Gas Piping Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Z Roof 3/12 Roof pitch
Total Sq. Ft of Construction: 1746 SFt. of First Floor: 1746
Cost of Construction: $ 12,800.00 Utilities:Cn Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Liphete Pierre Name: Roderick Walter
Address:2406 Holiday Ct Company: Sunrise City CHDO Inc
City: Fort Pierce State:FL Address: 130 S Indian River Drive
Zip Code: 34982 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.
1
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: E- Not Applicable MORTGAGE COMPANY: ✓Q Not Applicable
N am e:Liphete Pierre Name:
Add reSS:2406 Holiday Ct Fort Pierce,FL 34982 Address: 2406 Holiday Ct
City: Fort Pierce State: City: State:
I
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: ED Not Applicable BONDING COMPANY: ✓ LNot 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
commencinp work or recording our Notice of Commencement.
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Signat re of Owner/Lesse / ontractor as Agent for Owner Signature of Contractor/Lic nse 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 18 day of September 20 18 by this 18 day of September 120 18 by
Roderick Waller Roderick Waller
Name of person making statement Name of person making statement
Personally Known [Z]—OR Produced Identification Personally Known M_OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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(Signature (Signature of Motary Public-State of Florida)
d"r Notary Public scaea of Fkxide �. Note Public Steor Rg )
Commissio Sophia Huns (Seal) Commissio 'y
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ortxnrNipn GG 238873 �
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Expires 05!30/1020 lj My Commission GG 238873
M n Expires OS/30r2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17