HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I c n /
Date: 05/26/2020 Permit Nu mber: Z00.5 -� D4aS
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: To Select from dropbox, click here
Address: 6906 COQUINA AVE Fort Pierce, FL 34952
Legal Description: LAKEWOOD PARK -UNIT 9 - BLK 106 LOT 13 (MAP13/01N)
Property Tax ID #: 1301-611-0119-000-0
Site Plan Name:
Project Name: RENOVATION
Setbacks Front 25 Back: 15
Right Side: 13.5 Left Side: 13.5
Lot No. 13
Block No. 106
RENOVATION OF AN EXISTING SINGLE FAMILY HOME
AS PER THE ATTACHED PLANS en C) roz i Ex .
�JP� 'fr,1A4.3e,_T2 _Cor, e-t k
L�HVAC L__J Gas Tank
Electric 0 Plumbing
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under tins permit —cnecK all
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apply: 1
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)Oj' nve- 1 V2. 1 Jc"
Windows/Doors
Sprinklers
_Shutters
Generator
0
4l12 �ch
Roof �oofpitch
Total Sq. Ft of Construction: S Ft. of First Floor: 1,388
Cost of Construction: $ 14,400.00 Utilities:] Sewer 0 Septic Building Height: 12
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OWNER LESSEE ;s =
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,�ON'sTRACT�R
Name JBM PROPERTIES LLC
Name: RODERICK J WALLLER
Address: 5225 COLINS AVE APT #1111
Company: SUNRISE CITY C. H.D.O. INC.
City: FORT PIERCE
Zip Code: 34952 Fax:
Phone No.
State: FL
Address:
City: FORT PIERCE State: FL
Zip Code: 34950 Fax: 772-907-0420
Phone No. 772-201-2850
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: RODWALLER1 @GMAIL.COM
State or County License: CGC1515114
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
N
5UPPLEMENTALfiCONST[tUCTION
L'IENFLAW�INFOR gTION
TI
,:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement—
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Signature of Owner/ Less a/Contractor as Agent for Owner
Signature of Contractor/Lice se 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 26TH day of MAY 20_ by
this 26TH day of MAY 20_ by
RODERICK J WALLER
RODERICK J 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 of Notary u - t roc Fiy�S�A��u a of F1008
(Sign ture of Notary P lt� l g o R rris
02 Sophia Harris
23aB73
yy My Commission GG 236Y73
O§l�Od2020
05/3
Commission No. My fomr(iBBi9n GG
Commission NO. 05/30/2 0'p FxP�res �11
'fan EKpu, 05/30/2920
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17