HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/18/19 Permit Number: q 0 —
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Building Permit Application FEB 19 2018
Planning and Development Services.
Building and Code Regulation Division Permitting Departm@nt
St. Lucie County
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: matiggitge Siva,0
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Address: 3308 Meadow Ln,Fort Pierce FL
Legal Description: 17 35 40 W 100 FT OF N 1/2 OF S 1/2 OF SE 1/4 OF NE 1/4 OF NW 1/4-LESS S 15 FT OF
E 75 FT-(134)(0.35 AC)(OR 444-2483)
Property Tax ID#: 2417-214-0004-000-1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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1. Stucco Wood Patio in rear of house
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CONSTRUCTION INFORMATION
Additional,work to be erformed under this permit—check all}hat app y:
HVAC LI Gas Tank EGas Piping Shutters Windows/Doors
E.Electric LJ Plumbing Sprinklers Generator r Roof Roof pitch
Total Sq. Ft of Construction: 2510 S9:1:_ti of First Floor: 2510
Cost of Construction:$ 74)57- e9-. 2a00.0p Sewer E Septic Building Height:
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Name Annie L Moore Name: Roderick Waller
Address:3308 Meadow Ln Company: Sunrise City CHDO Inc.
City: Fort Pierce- State:FL Address: 130 S Indian River Drive
Zip Code: 34947 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 rodwaller1@gmail.com
from the Owner listed above) State or County License: Cie84527-2438 -6- i- t-CV1V
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: . Ea Not Applicable MORTGAGE COMPANY: la Not Applicable
Name:Annie L Moore Name:
Address:3308 Meadow Ln,Fort Pierce FL Address: 3308 Meadow Ln
City: Fort Pierce , State: City: State: -
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: El 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 1
-in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments. 1 .
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 1
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.
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Signature of Owner/Less--/Contractor as Agent for Owner Signature of Contractor/Lic nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucie County COUNTY OF St Lucie County
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The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before,me
this j8th day of February ,20 19 by' this J! L day of February ,20 19 by
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 Identification
Produced •. 'Produced
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(Signature• Notary Public-State of Florida) (Signature of ItOtary Public-State of Florida)
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, .-.,,ry Public S. :. of. !odds
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Commission No. • -- Commission No. 4.
4. ,, Notary Public State of Florida . . . '
'• 4'4'1'. Sophia Harris - . Sophia Hams
. i, My Commission GG 2313873 ..
diMy Commission GG 238873
Inotres-03130/2020 c,.sif- Expires 06/38/2020
REVIEWS ' — • '' I • • v SOR PLANS VEGETA Is S • I • L '( - •k —OVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE • • ,
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COMPLETED . .
Rev.8/2/17
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