HomeMy WebLinkAbout2807 JEFFERSON PKWY Fort Pierce BuildingPermitApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/23/21
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Re -Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 2807 JEFFERSON PKWY Fort Pierce, FL 34946
Property Tax I D #: 1428-702-1320-000-8
Site Plan Name:
Project Name: Re -Roof
Residential X
DETAILED DESCRIPTION OF WORK:
ReRoof (Remove old shingles and install shingles) FL10674 Shingles / FL2569 Underlayment
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
Lot No.
Block No.
Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator ❑✓ Roof Pitch
Total Sq. Ft of Construction: 2,400
Cost of Construction: $ 9,950.00
Sq. Ft. of First Floor: 2,400
Utilities: —Sewer —Septic Building Height: 15
OWNER/LESSEE:
CONTRACTOR:
Name Heriberto Aguilar
Name: Roderick Waller
Address: 2807 Jefferson Pkwy
Company: Sunrise City CHDO Inc.
City: Fort Pierce State: FL
Zip Code: 34946 Fax:
Phone No. 772-618-3828
Address: 130 S Indian River Drive Suite 202
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 rodwallerl@gmail.com
State or County License CCC1327208
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Q Not Applicable
Name: N/A
MORTGAGE COMPANY: Not Applicable
Name: N/A
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: ✓❑ Not Applicable
Name: N/A
BONDING COMPANY: ✓LNot Applicable
Name: N/A
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County 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 your Notice of Commencement.
Signature of Own�r/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF St Lucie County
Sworn to (or affirmed) and subscribed before me of
0 Physical Presence or Online Notarization
this 23rd day of March 2021 by
Roderick Waller
Name of person making statement.
Personally Known 0 OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No. Notary ptstaofFlonda
Eric H /
My Commission GG 913269
Expires 09/1512023
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF St Lucie County
Sworn to (or affirmed) and subscribed before me of
0 Physical Presence or Online Notarization
this 23rd day of March 2021 by
Roderick Waller
Name of person making statement.
Personally Known 0 OR Produced Identification
Type of Identification
Produced
(Signature of Notary Pu -
Notary Public State of Fbnde
Commission No. EricHaolF al)
My Commission GG 913269
OWExpires 09/15/2023
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Rev. 5/6/20