HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1
Date: Permit Number:
SCANNS0
By
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Building Per .11k, Application Ju,.
Planning and Development Services poNttj l d 1 ?§1B
Building and Code Regulation Division St n9 0
2300 Virginia Avenue, Fort Pierce FL 34982 �ocie 0 4an meet
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X n'
PERMIT APPLICATION FOR: Roof.
PROPOSED IMPROVEMENT LOCATION:
Address: 1750 TIMBERLAKE DR, Fort Pierce FL
Legal Description: TIMBERLAKE ESTATES LOT 33 (0.50 AC) (OR 567-1879)
Property Tax ID #: 2302-601-0037-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
i
DETAILED DESCRIPTION OF WORK:
Tear off shingles and install new shingles 34 Sq FL10124-Rf20=shingles/FL2346-R7=30#felt
CONSTRUCTION INFORMATION:
Additional work to be neFFo—rmed under tis permit -check all tha apply:
EHVAC E Gas Tank ❑Gas Piping _ Shutters Windows/Doors 1
F]Electric 0 Plumbing Sprinklers Generator W1 Roof 5/12 I Roof pitch
Total Sq. Ft of Construction: 2,244 S Ft. of First Floor: 2,244
Cost of Construction: $ Utilities: _Sewer Septic
12,300.00 Building Height:
R
OWNER/LESSEE:
CONTRACTOR:
Name James H Sullivan
Name: Roderick Waller
Company: Sunrise City CHDO Inc.
Address: PO Box 481
City: Fort Pierce State: FL
Address: 130 S Indian River Drive Suite 202
Zip Code: 34954 Fax:
City: Fort Pierce State: FL
Phone No.
Zip Code: 34950 Fax: 772-907-0420
Phone No. 772-201-2850
E-Mail:
Fill in fee simple Title Holder on next page (if different
E-Mail: rodwaller1@gmail.com
State or County License: CCC1327208
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ✓Q Not Applicable
Name: James H Sullivan
MORTGAGE COMPANY: ✓Q Not Applicable
Name:
Address: 1750 TIMBERLAKE DR, Fort Pierce FL
City: Fort Pierce State: FL
Zip: Phone
Address: Po Box 4s1
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: 21 Not Applicable
Name:
BONDING COMPANY: ✓ LNot Applicable
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 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
commencing work or recording vour Notice of Commencement.
IN
Signature of
STATE OF FLORIDA
CO U NTY OF St Lucie c
as Agent for Owner
The forgoing instrument was acknowledged before me
this 9th day of July , 20 18 by
Roderick Waller
Name of person making statement
Personally Known X
OR Produced Identification
Type of Id tifirntion
Produced ;:►°"•L'-
SOPHIA HARRIS
MY COMMISSION # FF997093
I
EXPIRES May 30, 2020
f4071398-0153
FloridahlotaryService.com _
(Signature of Notary Public- State of Florida )
on qo. I c- (Seal)
r
re of ContractorVLicense Holder
STATE OF FLORIDA
COUNTY OF St Lucie County
The forgoing instrument was acknowledged before me
this 9th day of July , 20 18 by
Roderick Waller
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Codnmiskion No.
MY COMMISSION # FF997003
EXPIRES May 30, 2020
N
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