HomeMy WebLinkAboutBuilding Permit Application (2)ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED )
Date: 02/06/20 Permit Number: ` 0
Building Permit Application
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 X
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION � � F' v � � a.
Address: 2504 NEWPORT DR, Fort Pierce FL 34982
Legal Description: ORANGE BLOSSOM EST -SECOND ADDN BLK 6 LOT 2 (0.29 AC)
Property Tax ID #: 2421-605-0037-000-4
Site Plan Name:
Project Name:
Setbacks (Front Back:
IWindow Replacement
Right Side: Left Side:
RK
Lot No.
Block No.
CONSTRUCTIONf
. IN FORMATION
w
ACICI itiona [.workto orme un er t is permit — c ec
fl
a
app y:
11HVAC
Gas Tank
Gas Piping
_
Shutters
Z Windows/Doors
Electric Q Plumbing
Sprinklers
Generator
Roof Roof pitch
Total Sq. Ft of Construction: 3271
S . Ft. of First Floor: 3271
Cost of Construction: $ 645
Utilities:
SewerEl
Septic
Building Height:
OWNER/LESSEE:. :.
CONTRACTOR;
Name.lamie McNair
Name: Roderick Waller
Address: 5259 NW South Lovett CIR
Company: Sunrise City CHDO Inc
City. Port St Lucie State: FL
Address: 130 S Indian River Drive Suite 202
City: Fort Pierce State: FL
Zip Code:; 34986 Fax:
Phone No.
Zip Code: 34950 Fax: 772-907-0420
E-Mail:
Phone No. 772-201-2850
E-Mail: rodwallerl@gmaii.com
Fill in fee simple Title Holder on next page (if different
State or County License: CGC1515114
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
,-SUPPLEMENTAL;CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: EL Not Applicable
.LL
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone:_
Name:
Address:
City:
Zip: Phone:
State:
Not Applicable I BONDING COMPANY: EINot Applicable
Name:_
Address:
City:_
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
rnmmanrina wnrk nr rernrdine vour Notice of Commencement.
Signature of Ownerk Lessee/Contractor as Agent for Owner
Ato_ntracto�rl_Uc
Signature of rise Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF St Lucie County
COUNTY OF St Lucie County
The forgoing instrument was acknowledged before me
this 6th day of February 2019 by
The forgoing instrument was acknowledged before me
this 6th day of February 20 19 by
Roderick Waller
Roderick Waller
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- r'
Public Stilt of Florida
Commission No. �� Harris
Signature of N 11,11111111
finPublic Stets of Fkxlda
mmission No. Sophia Hi.rris ICQ,I,
3
�j My Commission GG 236873
$aF Expires 05=020
Expires 05r3=020
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Rev. 8/2/17