HomeMy WebLinkAbout5702 Country Club Parkway Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/19/21 Permit Number:
� t C U,LCL`;M 10,
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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:
PROPOSED IMPROVEMENT LOCATION:
5702 Country Club Parkwav
rtyw caa. -
Property Tax ID #: 1301-604-0193-000-0
Site Plan Name: Walborn Re -Roof - flat roof only
Project Name: Walborn Re -Roof - flat roof only
DETAILED DESCRIPTION OF WORK:
Remove existing flat roof and replace with new
Polyglass USA - FL1654-R27
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ --,-) 10506
_ Generator
Sq. Ft. of First Floor:
Residential X
Windows/Doors
�oof
Lot No. 1
Block No.
_ Pond
Pitch
Utilities: —Sewer _ Septic Building Height: _8
OWNERAESSEE:
CONTRACTOR:
Name isa & Dale Walborn
Name: MiChael H. SaCk
Address: 5702 Country Club Parkway
companMB y: Enterprises Roofing eet eta ,
p Y�
City: Ft Pierce State:
Address: 540 2nd Street
_
Zip Code: 34951 Fax:
City: Vero Beach State: FL
Phone No.
Zip Code: 32962 Fax: - 69-47i-
E-Mail:
Phone No
Fill in fee simple Title Holder on next page ( if different
E-Mail mberoo Ing gmal .com
from the Owner listed above)
State or County License
it value of construction is Z5UU 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: — Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: , Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 mayhirestrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions wch 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/ Lessee/Contractor as Agent for Ownner,�
Sign ture of Contractor License Holder
STATE OF FLORIDpG�T
STATE OF FLORID_ / •
COUNTY OF C�,I% d
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COUNTY OF lifJCY� LEI
The f r ing instru i ijs jn wledged before me
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The fgqrgping instr t wa eknowledged b fore me
this / day of 20y
this day of,��
Name of person makingststaattgment.
Name of person making st ment.
Personally Known V OR Produced Identification
Personally Known OR Produced Identification
Type of Identificati
Type of Identification
Produced
Produced_ _
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Expires 10/0eT2023
Expires 10/0812023
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19