HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U
Date: 2/27/2017 Permit Number:
RECE1V7D MAR 22 7.017
I
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: Roof
P:ROPC)SED IM 'R01lEMENT,LQCAT1t?N
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Address: 164 SE SERENATA CT, PORT ST LUCIE, FL 34983
Legal Description: RIVER PARK-UNIT 5 BLK 47 LOT 7(MAP 34/28N) (OR 3926-2468)
Property Tax ID#: 3419-540-0144-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
1 b 71, ILED D �RIPT)ON 7�1NORK
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ReRoof(After the Fact) 1711 �, P\
Ct7(VSTRUCTI,O�I INFORMATI(7(U.
...
�;�..Additional work«.to e e orme .un e
rt ispermit—check all apply:
E1HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator 10 Roof
Total Sq. Ft of Construction: 1760 S Ft.of First Floor: 1760
Cost of Construction:$ 1600 Utilities:0 Sewer 0 Septic Building Height:
QUI/NER/LESSEE} CONTRACTOR
Name Principal Real Estate Development LLC Name: Roderick Waller
Address:3046 Sunrise BLVD Company: Sunrise City CHDO,Inc.
City: Fort Pierce State:FL Address: 3550 Okeechobee Rd
Zip Code: 34982 Fax: City: Fort Pierce State:FL
Phone No.772-579-5012 Zip Code: 34947 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@gmail.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.
SPP�: lIET�4L CQIUTUCT(ON 6!II LArN INlrC3RMATIONs.
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:
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 l 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 our Notice of Commencement:
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_Signature of Owner/Lesse /Agent Signature of Contractor/Lic nse Holder
STATE OF FLORI A STATE OF I'L0 14A.
COUNTY OF 5�. 1.13 COUNTY OF •t'• LU'CA
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this�� day of MQ�C 20 by thisal day of V`�•4v`(� 20 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu c-State of Florida) (Signature of Notary Pub ic-State of Florida)
Personally Known OR Produced I Personally Known ;f;r� inn
Type of Identification Pr MARIE GIVENS Type of Identificati
••'s:"•' 'r = MY COMMISSION#GG 021023
MY COMMISSION#GG 022023 ;*;
Commission No. �:Dawmber16.2020 - Commission No. )PPIRES:q $r16,2020
%P onded Thru Notary Public Underwdton
Bonded Thru Notary PublicUndenmters
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION 'SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE. Fie,/j
COMPLETE
INITIALS