HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 2-27-18ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: F1W 1T�D_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: Renovation
PR.OPOS'ED.I'IVIPROVE'IVIENT LOCATIAON ', ,
Address: 8301 DELAND AVE, FORT PIERCE FL
Legal Description: LAKEWOOD PARK -UNIT 5- BLK 56 LOT20 (MAP 13/02S) (OR 3539-817)
Property Tax ID #: 1301-605-0398-000-0 Lot No.
Site Plan Name: Block No.
Project Name: Renovation
Setbacks Front Back: Right Side: Left Side:
Repairs to address code violations. See attachment
:CONSTRUCTION INFORMATION
a
Additional work to be ertormed under this permit — check
11HVAC Gas Tank ❑Gas Piping
all
apply:
_ Shutters
Windows/Doors
❑✓— Electric
1i
E]Roof
Plumbing
Sprinklers
Generator
Roof pitch
Total Sq. Ft of Construction: 1506
S Ft. of First Floor: 1506
Cost of Construction: $ 1685
Utilities:
Sewer
Septic
Building Height:
OWNERjLESSEE
�CONTRAGTOR'
Name Ghazanfar, Saeed
Name: Roderick Waller
Address: 5201 Paleo Pines CIR
Company: Sunrise City CHDO Inc.
Address: 3550 Okeechobee Rd
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
City: Fort Pierce State: FL
Phone No. 772-359-3936
Zip Code: 34947 Fax: 772-907-0420
E-Mail:
Phone No. 772-201-2850
E-Mail: rodwaller1@gmail.com
Fill in fee simple Title Holder on next page ( if different
State or County License: CGC1515114
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
4Sl1PPLE,MENTAL CONSTRUCTION LIEN pLA1N INF.ORMATIOaN;
& , .,. w,m;Ya .;
DESIGNER/ENGINEER: Q Not Applicable
MORTGAGE COMPANY:
Q Not Applicable
N a me: Ghazanfar, Saeed
Name:
Address: 8301 DELAND AVE, FORT PIERCE FL
Address: 5201 Paleo Pines CIR
City: Fort Pierce State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: a Not Applicable
BONDING COMPANY:
allot 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
comraencing work or recording our Notice of Commencement.
Signs ure of wner/ Lessee/Contractor as Agent for Owner
Signature of ntractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF St Lucie County
COUNTY OF St Lucie County
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 27th day of February 20 18 by
this 27th day of February 20 18 by
Roderick
Roderick 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
ProdLiced
Prod
(Signature of Kotary Public- State of Florida)
(Signatur - I rida
Commissio SOPHIA HA �pj§
SOPHI
'�'`•',,q, �._. A HARR��IcqS
Commissi � � COMMISSION # FFB ?6b
'i MY COMMISSION # FF997093
EXPIRES May
'"' 1M1,. EXPIRES May 30, 2020
30, 2020
(407) 398-0153 FbrioaNOTaryService.com
REVIEWS
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
FRONT
ZONING
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev. 8/2/17