HomeMy WebLinkAboutBuilding Permit Application i
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/23/21 Permit Number: 0 q5 O
RECEIVED
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= Building Permit Application
pirmittwn9 DEpartment
Planning and Development Services St, Lucie Caurt'�
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: Re-Roof
P.RGyPt3SED,i flR0115lVlfaNT LOCATI
Address: 1817 SOUTHWEST DR Fort Pierce, FL 34946
Property Tax ID,#: 2406-501-0057-000-4 Lot No.
Site Plan Name: Block No.
Project Name: Re-Roof
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ReRoof(Remove old shingles and install shingles) FL10674 Shingles/FL2569 Underlayment
New Electrical Meter Second Electrical Meter
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Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator W1 Roof 4/12 Pitch
Total Sq. Ft of Construction: 1,334 Sq. Ft. of First Floor: 1,334
Cost of Construction:$ 8,600.00 Utilities: —Sewer _Septic Building Height: 10
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Name
Isaac Romulus Name:Roderick Waller
Address:1125 SW Coleman AVE Company:Sunrise City CHDO Inc.
City: Port St Lucie State: FL Address:130 S Indian River Drive Suite 202
Zip Code: 34953 Fax: City: Fort Pierce State:FL
Phone No.772-618-3828 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 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.
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DESIGNER/ENGINEER: Q Not Applicable MORTGAGE COMPANY: ✓� Not Applicable
Name:N/A Name:N/A
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: ✓a Not Applicable BONDING COMPANY: ELNot Applicable
Name:N/A 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 oLrecordingyour Notice of Commencement.
Signature of Own'r/Lessee/Contractor as Agent for Owner Signature of Contr ctor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucie County COUNTY OF St Lucie County
Sworn to(or affirmed)and subscribed before me of 'Sworn to(or affirmed)and subscribed before me of
[ Physical Presence or Online Notarization ED Physical Presence or Online Notarization
this 23rd day of April 2021 by this 23rd day of April 2021 by
Roderick Waller Roderick Waller
Name of person making statement. Name of person making statement.
Personally Known�_OR Produced Identification Personally Known_ ✓�OR Produced Identification
Type of Identification Type of Identification
Produced`' Produced
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(Signature of Notary Public-State;of Florida) (Signature of Notary Public-State of Florida
C N Public ROLNlo (Seal) Commission No. eS a
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COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
iev. 5/6/20