HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/25/2019 Permit Number: ' O
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Building Permit Application
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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 XXX
PERMIT TYPE: RE - ROOF
Address: 2909 Grove DR FORT PIERCE, FL 34947
Property Tax ID#: 2420-810-0002-000-7 Lot No. 1 &2
Site Plan Name: Block No.
Project Name:
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Additional work to be performed under this permit–check all that apply:
—Mechanical' _Gas Tank _Gas Piping _Shutters . _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator Roof 3/12 Pitch
Total Sq. Ft of Construction: 8,084 Sq. Ft.of First Floor:
Cost of Construction:$ 9,987 Utilities: —Sewer _Septic Building Height: 23 FT
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CONTRACTORS'
NameJose A. Montoya Name: RODERICK WALLER
Address:2909 Grove Dr Company: SUNRISE CITY c H D O, INC.
City: FORT PIERCE State:_ Address: 130 S. INDIAN RIVER DR.#202
Zip Code: 34947 Fax: City: FORT PIERCE State: FL
Phone No. Zip Code: 34950 Fax: 772-907-0420
E-Mail: Phone No772-201-2850
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.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _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 thepermit 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND;TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENC ENT."
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Signa ure of Ow er/Lessee/Contractor as Agent for Owner Signature of Contractor icense 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 25th day of OCTOBER 20a, by this 25th day of OCTOBER 20b
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RODERICK WALLER
Name of person making statement. Name of person making statement.
Personally Known xxx OR Produced Identification Personally Known — OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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(Signature of Notary Public-State of Florida) (Signature of 6otary Public-State of Florida)
Commission No.
O. .�'v .,, No@94)c State of Florida
,W04 Notary Public St to of Florida Sophia Harris
Sophia Harris �` MY Commission GG 238873
MY cOmmissioGG 238873
REVIEWS FRONT ZAgf S I E �2 20 PLANS IEGETATION SEA U L
COUNTER REVI REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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