HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED
'
Date: 231 V
(K�
APPLICATION TO BE ACCEPTED 1
Permit Number: (J
I S6ANN
WG An —
Build er�i'iit Application 4PR18
Planning and Development Services �i!( 1ff
Building and Code Regulation Division St Z49
cle DCouh'h'�enr
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof I
PROROSED IIVI'PROUEMENT LQ`CATI6N�3.
Address: 6803 Sebastian RD Fort Pierce, FL 34982
Legal Description: LAKEWOOD PARK -UNIT 12- BLK 160 LOT 28 (MAP 13112S) (OR 469-2638; 4104-2924)
Property Tax ID #: 1301-614-0118-000-2
Site Plan Name:
Project Name:
Setbacks Front Back:
;`OF W01
Replace Shingles to Metal/ 8sq Flat section
Lot No.
Block No.
Side: Left Side:
Additional work to be nertormed under is permit' — check
a
apply:
�HVAC
Gas Tank
Gas Piping
_Shutters
Q
Windows/Doors
11 Electric ❑ Plumbing
❑Sprinkle rs
Generator
W1
Roof 4/12 Roof pitch
Total Sq. Ft of Construction: 2728
Sq.of First Floor: 1952
Cost of Construction: $ 10,500.00 •
Utilities: L__I
I
Sewer 11 Septic
Building
Height:
QWNER%LESSEE ;=h
CONTRACTOR
Name dames F Shinn
Name: Roderick Waller
Address: 1708 Wyonming Ave
Company: Sunrise City CHDO Inc.
City. Fort Pierce State: FL
Address: 3550 Okeechobee Rd
Zip Code: 34982 Fax:
City: Fort Piece State: FL
Phone No.
Zip Code: 34947 Fax: 772-907-0420
E-Mail: i
Phone No. 772-201-2850
E-Mail: rodwaller1@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above) I
State or County License: CCC1327208
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
-6Sl1PPLEMENTAL"
CONSTRU�CTI"ON'LIxE,S(�
LAIN 1N
ORMATIO�V
DESIGNER/ENGINEER:
Q Not Applicable
MORTGAGE COMPANY:
Q, Not Applicable
N am e: James F Shinn
I
Name:
Address: 1708 Wyonming Ave
City:
State:
Address: 6803 Sebastian RD Fort Pierce, FL 34982 I
City: Fort Pierce State:
Zip: Phone
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
0 Not Applicable
BONDING COMPANY:
allot Applicable
Name:
I
Name:
Address:
I
Address:
City:
City:
I
Zip: Phone:
Zip: Phone:
I
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 perlmit, 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, �igns, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to RecorcIl 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 olbtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
jj�'k
n QI�CJ� I
WU),
Signature of Owner/ DAssee/Contractor as Agent fo Owner
Signature of Contractor/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 18th day of April 12018 by
this 18th day of April 20 18 by
Roderick Waller
Roderick Waller
Name of person making statement I
Name of person making statement
Personally Known X OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Prod ced
Produced
(Signat - e
:��� SOPH PA
Commi Sit)n ;'. MY COMMISSION # FF�
(Signature o o i�,�� -SOPHIA HARRIS
Commission N�'. :�= MY COMMISSIOf`45ff097093
's'�;�
EXPIRES May 30, 2020
„ , •
(407) 399-0153 FloriAallotaryServirs.com
EXPIRES May 30, 2020
tda�.t3-0�s� FbridallotarySemc® com
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev. 8/2/17