HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 2
3/12/2020 F CD 3 •DNS
Date: Permit Number:
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
PERMIT TYPE: Re-Roof
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Address: 398 GOKCHOFF RD, FORT PIERCE FL
Property Tax ID#: 2310-801-0043-000-0 Lot No.
:Site Plan Name: Block No.
Project Name:
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Re-Roof(Tear off old shingles and replace with, j/ /P/zi
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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 Pitch
Total Sq. Ft of Construction: 2448 Sq. Ft.of First Floor: 2448
Cost of Construction:$ 9500.00 Utilities: —Sewer —Septic Building Height:
a � e ' �wl � TR 7CON Name Remberto&Edith Flores Name: RODERICK WALLER
Address:398 Gokchoff Rd Company: SUNRISE CITY CHDO, INC.
City: Fort Pierce State: FL Address: 130 S. INDIAN RIVER DR. #202
Zip Code: 34945 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 RODWALLER1 @GMAIL.COM
from the Owner listed above) State or County License CGC1515114
-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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/Le see/Contractor as Agent for Owner Signature of Contractor/Ti cerise Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST.LUCIE COUNTY OF ST.JUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 12th day of March 20 20 by this 12th day of March 20 20 by
RODERICK WALLER RODERICK WALLER
Name of person making statement. Name of person making statement.
Personally Known XX OR Produced Identification Personally Known XX OR Produced Identification
Type of Identification Type of Identification
Pro u d Produced
(Signature of Notary PublicQStaof�F�Ior&dal
gna ure d Notary Public- to of Florida )
Commission No. (Seal) Commission Seal)
LASHAI►NAINGRAIy_ MING
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