HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED —1
Dat I:T ' �� SCANNED Permit Number:
p . _ BY RECEIVED
t St. ,linos County
Building Permit Applicati " n
Planning and Development Services ST. Lucie County, Permitting
Buill ng and Code Regulation Division
ii
230 q , Virginia Avenue, Fort Pierce FL 34982
Pho I e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
s
EP
R, IT APPLICATION FOR: Roof
Addn
Legal
Prol
Site
Proi
3111 Avenue R, Fort Pierce FL 34947
cription: SUNRISE PARK NO 1 BLK 5 LOTS W 1/2 OF LOT 6, LOTS 7 AND 8 (0.42 AC) (OR 959-513)
y Tax ID #: 2405-501-0098-000-0
n Name:
Name:
ks Front Back: Right Side
Lot No.
Block No.
Left Side:
Tear cif and Install New Shingles FL10124-R20 26 Sq / Underlayment FL2346-R7
Flat 41Sq FL1654-R2
I,IJIV�I'tt_Ul.-LIl)IV-IN;rUKIVIi0
{
Additional
❑_
work to a e
VAC 11
orme under this permit —check
Gas Tank Piping
❑Gas
al
apply:
Shutters
❑
Windows/Doors
_
❑
lectric 0 Plumbing
Sprinklers
❑ Generator
Z
Roof Roof pitch
Total S�.
Ft of Construction: 1960
S . Ft. of First Floor: 2960
Cost o
Construction: $ 6500
Utilities:InSewer []Septic
Building
Height:
OWNED/LESSEE K
,CONTRACTOR
Name �immy E Lloyd
Name: Roderick Waller
Address: 3111 Avenue
Company: Sunrise City CHDO Inc.
City: Fort Pierce State: FL
Address: 130 S Indian River Drive Suite 202
Zip Code: 34981 Fax:
City: Fort Pierce State. FL
Phone I o.
Zip Code: 34950 Fax: 772-907-0420
E-MailI,
Phone No. 772-201-2850
Fill in f, a simple Title Holder on next page ( if different
E-Mail: rodwaller1@gmail.com
from t�e Owner listed above)
State or County License: CCC1327208
If value'bf construction is $2500 or more, a RECORDED Notice of Commencement is required.
DES
117,VNfl§�;' )5ONG"
GNER/ENGINEER: Not Applicable MORTGAGE COMPANY: a Not Applicable
Na
e: Jimmy E Lloyd Name:
Address-.
3111 Avenue R, Fort Pierce FL 34947 Address: 3111 Avenue
City
Fort Pierce State: FL City: State:
Zip:
Phone Zip: Phone:
FEE
TITLE HOLDER: El Not Applicable
BONDING COMPANY: ELNot Applicable
Nan
e :
Name:
ess:
Add
Add'
Address:
City:
City:
Phone:
Zip: Phone:
Zip:
OWN
ER/ CONTRACTOR AFFIDVIT:'Application is hereby made to obtain a permit to do the work and installation as indicated.
I certfly
that no work or installation has commenced prior to the issuance of a permit.
St. Luc
which
structi
e County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
s in conflict with any applicable Home Owners Association rules, bylaws or ancovenants that may restrict or prohibit such
re. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In con'�
ideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in acc(
rdance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The fo
access
lowing building permit applications are exempt from undergoing a full concurrency review: room additions,
)ry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WAR
4ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements
befor
to your property. A Notice of Commencement must be recorded and posted on the jobsite
2 the first inspection. If you intend to obtain financing, consult with lender or an attorney before
com
'I encing work or recording your. Notice of Comme cemenj.
I'
Signature of Contracto License Holder
Sign
ure of owner/`La s ee/Contractor as Agent or Owner
STATE
CO
OF FLORIDA
I NTY OF St Lucie County
STATE OF FLORIDA
COUNTY OF St Lucie County
The I
rgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this .
6th day of -July 20 18 by
this 26th day of July 20 18 by
Rod i
rick Waller
Roderick Waller
Name of person making statement
II
Name of person making statement
Pers
nally Known X OR Produced Identification
Personally Known X OR Produced Identification
TyPE
of Identification
Type of Identification
Prod
iced
Pro d—Oced
(Signature
0 N i
I - t f 11
r
(Signature of Notai 11 111 1 li t f I
Notar
Commission
Notary Public of
SO hi. U.
M
My Commission n
EX i 238873
P res 0
fay 5 020
Public
P4!" Amtj�' Notary Public State �F
Commission N e! War) a
', Stele
=P
H ms mm
my Commission GG 2....
My GI 7G 036673
Expires 05=020
Expire, 0 02
RE
IEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
REC
IVE
DAT
CO"
PLETED
Rev. 8
2/17