HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL
Da
LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,Q
SCANNED Permit Number:
BY
92fi St Lucie County
RECEIVED
Building Permit Application CCD 19 2018
Plan 'ing and Development Services
Build" and Code Regulation Division
230 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
Permitting Department
St. Lucie County
Residential X
PER
II IT APPLICATION FOR: Roof
PRO
OSED IIVfPROV'EIVI'ENT LOCATION � � "� '� � ,,�. ��
Addri
Legal
7001 LAKELAND BLVD, Fort Pierce FL
cription: LAKEWOOD PARK -UNIT 10- BLK 123 LOT 19 (MAP 13/01S) (OR 1506-2769)
Prop irty Tax ID #: 1301-612-0129-000-6
Site Plan Name:
Proje It Name:
Setb cks Front Back:
Right Side: Left Side:
Rem ve and replace Shingles with 5v Metal f L aD��y ►�
Ui erL$jms__t 301b Pe(r FC�Z3 O
Lot No.
Block No.
Add
i iona wor to e e orme under this permit— c ec all apply:
HVAC 0 Gas Tank DGas Piping _ Shutters ❑ Windows/Doors
❑ Electric ❑ Plumbing Sprinklers Generator Roof 4�12 Roof pitch
Total ISq. Ft of Construction: Sli
of First Floor: 2798
Cost f Construction: $ 9950.00 UtilitiesSewer Septic Building Height:
OWiNER/LESSEE
r h'
r'CONT,RACTOR
Nam
Address:
City.
Zip Clode:
Phor
E-M
Fill itil
from,the
Marcus L Dixon
Name: Roderick Waller
7001 LAKELAND BLVD
Company: Sunrise City CHDO Inc
Address: 130 S Indian River Drive
I;Fort Pierce State: FL
34951 Fax:
a No.
City: Fort Pierce State: FL
Zip Code: 34947 Fax: 772-907-0420
Phone No. 772-201-2850
ail:
fee simple Title Holder on next page ( if different
Owner listed above)
E-Mail: rodwaller1@gmail. corn
State or County License: CGC1515114/CCC1327208
If valyie of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPiPLEMENTAL
CONSTRUCTION LIEN LAW INFORMATION;
.°aF„ e doufr . ,.:, :.,,. P 5. .� wi�a .v 6' 7aa`
DESIGNER/ENGINEER:
Nam
Address:
City:
Zip:
Not Applicable
I e: Marcus L Dixon
MORTGAGE COMPANY: Q Not Applicable
Name:
7 001 LAKELAND BLVD, FortPierce FL
Address: 7001 LAKELAND BLVD
(FortPierce State:
Phone
I
City: State:
Zip: Phone:
FEE
Nale:
Addmmress:
City:
Zip: ICI
SIMPLE TITLE HOLDER: 2:1 Not Applicable
BONDING COMPANY: Q_Not Applicable
Name:
Address:
City:
Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certi that no work or installation has commenced prior to the issuance of a permit.
St. Lucile 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
struct le. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In con �deration 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,
accessary structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WAR ING 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
befor the first inspection. If you intend to obtain financing, consult with lender or an attorney before
comniencing work or recording our Notice of Commencement.
4ofOw/
Signature of Contra for/License Holder
Sign
L see/Contractor as Agent for Owner
ii
STA
COUNTY
E OF FLORIDA
6c;
STATE OF FLORIDA
OF LUeC
OF
COUNTY
Thefor
this
oin instrument wa acknowled a efore me
-I ay of Se�C crz�e� 20by
The forgoing instru ent �y✓as cknowledg efore me
this .day of �pjj'7 L:�/ 20by
Personally
Name of person making statement
Known OR Produced Identification
Name of person making statement
Personally Known OR Produced Identification
Type
of Identification
Type of Identification
Prodl
ced
Prod ced
(Signature Notary Public- State of Florida )
(Sig
ature of Notary Public- State of Florida)
Com
ission No. ty'Pu4g�ofFiorfWs
Commission No. a�
rY Pubilc ��florida
Sophia Harris
C misswn GG 236873
My ,
!X*jros
Sophia Hams
My Commission GG 238873
05I30Y2020
Ex Iran 051
RE
IEWS
FR
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
M G OVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DAT
�
REC
HIVED
DAT
COMPLETED
tev. 8 I2/17