HomeMy WebLinkAboutBUILDING PERMIT APPLICATION�1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �' iP - SCANNED
Permit Number:
BY
_ ___ - st Lucie count
Building Permit Application
Planning and Development Services
Building and Code Regulation Division FEB 16 2018
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Roof
PROPOS;ED]M:PROVEMENT'LO°CATIO'N . `
Address: 2511 Chesterfield Drive, Fort Pierce FL
Legal Description: SAN LUCIE PLAZA S/D-UNIT ONE BLK 59 S 5 FT LOT 23 AND ALL LOT 24 AND N 25 FT
OF LOT 25 (MAP 14/29S) (OR 3982-2317)
Property Tax ID #: 1428-702-1340-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRI:PTIOWOF WC►.RK
Remove and Replace 35 sq Shingles / 5 sq of Flat Torchdown
4/�2P
CONSTRUCTION- INFORMATION
°
Additional work to be performed under tis permit —check
11HVAC �1 Gas Tank Gas Piping
all
apply:
_Shutters
a Windows/Doors
Electric � Plumbing
Sprinklers
Generator
Roof Roof pitch
Total Sq. Ft of Construction: 3840
S Ft. of First Floor: 1798
Cost of Construction: $ 6950.00
Utilities:In
Sewer
[]Septic
Building Height:
01NNERL.ESSEE
;CONTRACTOR:
Name Cary W
yn i e—
Name: Roderick Waller
Company: Sunrise City CHDO Inc.
Address: 3550 Okeechobee Rd.
City: Fort Pierce State: FL
Zip Code: 34947 Fax: 772-907-0420
Phone No. 772-201-2850
Address:
City: Port St Lucie State: FL
Zip Code: 34953 Fax:
Phone No. L[ ® l)
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.
SUPPLEMENTAL CONSTRUCTION -'L[E (A INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Q Not Applicable
Name: Chibert Fervily
Name:
Address: 2511 Chesterfield Drive, Fort Pierce FL
Address:
City: Port St Lucie State:
City: State:
Zip: . Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: EJ Not Applicable
BONDING COMPANY: Eallot 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 ancovenants 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
commencing work or recording ygur Notice of Commencement.
Signature of owner/ Le see/Contractor as Agent for
Signature of ontractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF St Lucie County
OUNTY OF St Lucie County
rn _<
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The forgoing instrument was acknowledged before m
he forgoing instrument was acknowledged before`
thisl5th day of February 20 18 by rn
mu,
his _ day of February 20 18 rn--
by
)y �q V5 U3
C' W
7
�g —se.
aa M 0
Roderick Waller
odedck Waller ir 12K
Name of person making statement a
Name of person making statement
Personally Known X OR Produced Identification
Produced Identifica C,
ersonally Known X OR Pr fica
Type of Identification rQ
pe of Identification
Produced
oduced
AA
( ignature of N 01 y Public- St —ate of Florida
(Signature of N&y Iyublic-_§tate of'Flor0a
Commission No (Sea])
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17