HomeMy WebLinkAboutBuilding Permit Application L
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 _
Date: O'd7' )73 Permit Number:
RECEIVED
Building Permit Applicatio NOV 2-8 2018
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Les% WF.iexCounty1AFL
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
RROPOSED.I IVIPROVEIVIENT:LOCATION
Address: 2221 Juanita Ave FT. Pierce FL 34947
Legal Description: PARADISE PARK BLK 12 LOT 9 & 10 (OR 887 - 1335)
Property Tax ID#: 1433 -701 -0218 -000- 6 Lot No. 9 & 10
Site Plan Name: Block No. 12
Project Name:
Setbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
DETAILED DESCRIPTION OF WORK
.. , .0 ;
RE-ROOF Shingles FL 10124 /Underlayment FL16048
CONSTRUCTION INFORMATION
Additional work to be nertormed
, under t ispermit—c ec a Tat appy:
E:] Pin
❑HVAC Gas Tank Gas Pi MGenerator
Doors
g Shutters Windows/Electric Plumbing Sprinklers Roof /Z Roof pitch
Total Sq. Ft of Construction: 5,380 S . Ft.of First Floor: 2889
Cost of Construction:$ 17,490 Utilities:Sewer Septic Building Height: 17
OV1/iV:ER%LESSEE 'S
CONTRACTOR
Name IRENE DIXON Name: RODERICK J WALLER
Address: P . 0 . BOX 1746 Company: SUNRISE CITY C. H. D. O. INC.
City: FT. PIERCE State: FL Address: 130 S. INDIAN RIVER DR. #202
Zip Code: 34954 Fax: City: FT. 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: CCC 1327208
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPRLEMENTAL CbNSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: N/A Name: N/A
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 130 S.INDIAN RIVER DR.#202 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 our otice of Commencement.
"Al
Signature of Owner/Le eV/LVntractor as Agent for Owner Signature of Contractor/Lic rise Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF rr ,� COUNTY OF ST- Lyr'f'!�'
The forgoing instr ment as acknowledge before me The forgoing inst ment was acknowledged before me
this day of al)LPh6r 20jy by thisday of Jac► 20) by
ir,�fc
WAI �a d��;plc A ( 1 e7r
Name of person making statement Name of person making statement
Personally Known )e,, OR Produced Identification Personally Known V OR Produced Identification
Type of Identification Type of Identification
Pro d Produce
(Signature of lNotary Public-State_pIT Florida (Signature oaf igta P i
Co m m iss n Notary Public Smote of FI I ;�+ Notary Public State of Florida
) Commission of � Sophia Harris Seal)
• Harris commission GG 238873
y; M,Commission GG 238873 '�J
Expires p63012020
4aA Expiresosf30/2020 swat•
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17