HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date 11/8/19 Permit Numb r•TRUP
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Building Permit Application NOV 8 2019
Planning and Development Services Permitting Department
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 �t. Lucie County, ('L
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION ,
Address: 2507 Chesterfield Dr Fort Pierce, FL 34982
Legal Description: ORANGE BLOSSOM EST-SECOND ADDN BLK 2 LOT 4 (0.20 AC)(OR 1789-2663)
Property Tax ID#: 2421-605-0011-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION QF WORK , � ' ; ,et
�e
1,''
Tear off old shingles and replace with new shingles(FL10124, Underlayment Felt Buster NOA
18-0119.15 Synthetic) --- Replace Flat roof section 8sq (FL1654)
E.
J. NSTRUCTION INFORMATION °'�� � ',d� ' ' x "
Additional work to be pertormed under this permit–c ec a appy:
❑HVAC Gas Tank Gas Pi Windows
— ❑ in Piping Shutters Doors❑ /
❑Electric ❑ Plumbing Sprinklers ❑Generator Z Roof 3/12 Roof pitch
Total Sq. Ft of Construction: 2756 SFt.of First Floor: 2756
Cost of Construction:$ 8,850.00 Utilities:n Sewer❑Septic Building Height:
ER/LESSEE �� ` �
;.CONTRACTYUR� =F . .6.4, ,` ... ,r ',
Name Mimose PercevalName: Roderick Waller
Address:2507 Chesterfield Dr Company: Sunrise City CHDO Inc.
City: Fort Pierce State:FL Address: 130 S Indian River Drive Suite 202
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@gmaii.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.
SUPPLEMENTAL CONSTRUCTION�°LIEN LAW INFORMATIONg{, � R �
Aw, "4`�r'F'f:..
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Q Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: E] Not Applicable BONDING COMPANY: allot 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 o recorclinlg your Notice of Commencement. lq
Signature of Owner/Lessee/Contracto as Agent for Owner Signature of Contractor/License older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucy County COUNTY OF St Lucie County
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 8th day of_November 20 19 by this 8th day of November 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
(Signature of Notary publi ignature of Ncftary Public-St a;of Florida°ryNotary Public State of Florida °Commission No. ,` oGrp )Public State of Florid
S6 )Harris ommission No. MOP
Hards
Ex Commission 20 238873 �C.omm Commission GG 238873
Expires 05/30/2020 A r 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