HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /iO6_0 IV
Date: Permit Nu MGM $W�
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Bu§19110nCg11AP_Ce6rN1�i't Applicatio JUN 0 7 2018
Planning and Development Services
Building and Code Regulation Division LPermitting Department
S L
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial la
PERMIT APPLICATION FOR: Roof
RR't OVEME N
Address: 951 FRA MAR PL, Fort Pierce FL
Legal Description: WAGNER S/D BLK I LOT 7 (OR 4066-2085)
Property Tax ID#: 2427-702-0007-000-1
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
'DET,,A�i�LED"'D'E'S,"','CRI.PT"1. 0 N,,' F-,WO,RK"
Re -Roof - Tear off and install 5v metal Main Roof (FL1 6048-R6, FL20484-Rl)
TPO for Flat Section (FL5293-R28)
Lot No.
Block No.
CWTRLICTION.� IN,FQRMATIOW
Additional work to be i)ertormed under
E1HVAC Gas Tank
this permit— check
OGas Piping
all
apply:
Mutters
11 Windows/Doors
Electric F-1 Plumbing
OSprinklers
Generator
W1 Roof Roof pitch
Total Sq. Ft of Construction: 1568
ScLFt f R t Floor: 1568
irs
Cost of Construction:$ 7500.00
Utilities
: no
—SeweroSeptic
Building Height:
M�,
tONTRAcfbA:,
Name Henri LaFrance
Name: RoderickWaller
Address: 5521 Lakeview Mews TER
Company: Sunrise City CHDO Inc.
City: Boynton Beach State: FL
Address: 1209 S Indian River Dr
City: Fort Pierce State: FL
Zip Code: 33437 Fax:
Phone No.
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: rodwallerl@gmall.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.
SUP,P,LEM,E�N,T,A�L,"C�,P-NSTR"�JCTI;ON�,-LI'EN',L;AW,INFORMATION'���:�,�',�,*'"'
DESIGN ER/ENGIN EER: Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name: Henri LaFrance
Name:
Address: 951 FPA MAR PL, Fort Pierce FL
Address: 5521 Lakeview Mews TER
City:
State:
City: Boynton Beach State:, FL
Zip: . Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: F-1-1 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
compvncing work or recording Vour Notice of Commencement.
Signature of Owner/ Lestee/Contractor as Agent for Owner
Signature of Contractor/Licen te 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 4th day of June 20 18 by
this 4th day of March ------- 1 20 18 by
Roderick Waller
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
Produced
Produced
qt)PI41A WAPPIQ
w�a�-A- k- lAl"t—
(Signature of Notary PL 6r�� ;iTt- wizidgkio N # FF997093
t
�0 a ure o tlXAffVAP4kA(RAJ8te of Florida
EXPIRES May 30, 2020
MY COMMISSION # FF997093
Commission No. ) PiServ".c'
-Asion ARAss may 3p, (Seal)
11407) 398-01 3 FlorwsNotarySerme.com
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Rev. 8/2/17