HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
)Date: RzCzJVz
BY JUN .,9
GOVIIININ 12018
. ... .... WAle Permitt, . 1790
BUU1, I Permit Application
g St. Lucie epattr
nent
Planning and Development Services CO,,t.,,
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Commercial Residential X
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Roof
Q 'T b 011,
Address: 6110 Deborah WAY, Fort Pierce FL,
Legal Description: LAKEWOOD PARK -UNIT 5- BLK 52 LOT21 (MAP 13/02S) (OR 4105-2016)
Property Tax lD#: 1301-605-0287-000-9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Q,ETA
DESCRIPTION
-WORK UYA
"VQ PR& Sec�1G^'Ojo\
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NOT Z)vt'-7 r-)P-fcckJ
A N"' P,
Additional work to be nprtormed under this permit — chec k all that appi
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EIHVAC Gas Tank E]Gas Piping Shutters Windows/Doors
Electric El Plumbing OSprinklers El Generator Roof 4112 Roof pitch
Total Sq. Ft of Construction: 1508 S Ft of First Floor: 1508
Cost of Construction: $ 500.00 Utilities,Sewer ElSeptic Building Height:
V,
Name Michael Zeugner ETAL
Name: Roderick Waller
Address: 1550 Quiescent LN
Company: Sunrise City CHDO Inc.
Address: 130 S. Indian River Drive Suite 202
City: Sebastian State: FL
Zip Code: 34950 Fax:
City: Fort Pierce State:/ F
Phone No.
Zip Code: 34950 — Fax: 772-907-0429
E-Mail:
Phone No. 772-201-2850
Fill in fee simple Title Holder on next page (if different
E-Mail: rodwallerl@gmaii.com
from the Owner listed above)
State or County License: Cccl 327208
is required.
If value of construction is $2500 or more, a RECORDED Notice of Commencement
1
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SUPPLEMENTALhCONSTRIJCT(sQN LIN LAU1lINFORMA
ION;
DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Q Not Applicable
N a me : Michael Zeugner ETAL
Name:
AddreSS: 6110 Deborah WAY, Fort Pierce FL
Address: 1550 Quiescent LN
City: Sebastian
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: 0
Not Applicable
BONDING COMPANY:
✓ LNot Applicable
Name:
Name:
Address:
City:
Address:
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 C�rtify 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 11
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 vour Notice of Commencement.
i
Signature of Owner/ L dssee/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 22th day of June 20 18 by
II
this 22th day of June 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
((Signature
'HAMS
(Signature
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; ,?!"'"•"arti: S.OPHIA
jig. - SOPHIA HARRIS
Commissio
,�Vo ' MY COMMISSION #( g093
Commissio
-No '_ M C MMISSION # F§eai�3
•',ao,;�;. EXPIRES May 30, 2020
'? rid' EXPIRES May 30, 2020
(407) 398-0153 FloridahlotaryService.com
(407) 398-0153 Floridahlotaryservice.com
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8/2/17