HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1d��1 A� Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
RECEIVED
OCT 0 9 2018
ST. Lucie Cownt}, Permitting
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof — took- dJ 9 r ,rev ��11 M NNED
Address: 6601 Coquina AVE, Fort Pierce FL
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Legal Description: LAKEWOOD PARK -UNIT 9- ELK 115 E 73 FT OF LOT 19 (MAP 13/01 N) (OR 3505-2584
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Property Tax ID #: 1301-611-0316-000-1 Lot No._
Site Plan Name: Block No.
Proiect Name:
Setbacks Front Back: Right Side: Left Side:
Roof (Over with 5v Metal �� r 1
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�IElectric 0 Plumbing S rinklers � Roof
Total Sq. Ft of Construction: 1508 S Ft. of First Floor: 1508
11 Cost of Construction: $ 12,500 Utilities. Sewer Septic Building Height:
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"Shutters
Generator
Windows/Doors
Roof pitch
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01NNER/LESS E���
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Name ,Eddie R Taylor
Name: Roderick Waller
Address: 6601 Coquina AVE
Company: Sunrise City CHDO Inc.
City: Fort Pierce
State: FL
Address: 130 S Indian River Drive Suite 202
Zip Code: 34951 Fax:
City: Fort Pierce State. FL
Phone No. 7 - 8 O
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Zip Code: 34950 Fax: 772-907-0420
E-Mail: '� a-- PIo I -
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Phone No. 772-201-2850
E-Mail: rodwaller1@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: CCC1327208
If valuelof construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: Q Not Applicable
MORTGAGE COMPANY:
✓a Not Applicable
Name: Eddie RTaylor
Name:
Address: 6601 Coquina AVE
Address: 6601 Coquina AVE, Fort Pierce FL
Cit�: Fort Pierce State:
City:
State:
Zip: Phone
Zip: Phone:
FEEI SIMPLE TITLE HOLDER: 0 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
whichiis in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
ct struure. 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 folllowing 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 your Notice of Commencement.
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Signature of Con actor/License Holder
Signature of Owner/ Lesse /Contractor as Agent for Owner
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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 9th day of October 20 18 by
this 9th day of October 20 18 by
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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
Prod ced
Produce
(Signature of Notary Public- State of Florida )
(Signature 8f Notary Public- State of Florida
NOt°ry e�pdda
Corn ission NFOP
Commissio o
Sty of Florida
My Cortnni wi m GG 238873
Expires 115130/2020
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` MY �orrmlfafiDn GG 238873
REVIEWS
FRONT
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SUPERVISOR
PLANS
VEGE A I
ANGROVE
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COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev.8/2/17