HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONe-
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /'� I 13 r_
Date: 110/29/18 Permit Number: I V 1�
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Building Permit Application per 810�8
Planning and Development Services muting p
Building and Code Regulation Division 3( Luc/e Coy fimQnt
2300 V, �rginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
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PROPQSED IMP,ROU�EMENTLOCATION,
Address: 6505 PENSACOLA RD, FORT PIERCE, FL S# hicle-COLITI}�Q
Legal Description: LAKEWOOD PARK -UNIT 10- BLK 121 LOT 17 (MAP 13/01S) (OR 3574-812) 6�
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Property Tax ID #: 1301-612-0070-000-7
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Remove old shingles and install new 5v metal
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Lot No.
Block No.
�CON`ST.RUCTION(N'FORIVIATION
..
�x
Addit! I o na workto be pej orme under
this permit — check
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apply:
LJHVAC
LJ
Gas Tank
[]Gas Piping
In
Shutters
a Windows/Doors
DiElectric ❑ Plumbing
Sprinklers
❑ Generator
W1 Roof 4�12 Roof pitch
Total Sq. Ft of Construction: 1664
S Ft. of First Floor: 1664
Cost of Construction: $ 6230.00
Utilities.
Sewer
Septic
Building Height:
Q1IVIVER%L'ESSEE ''
...._ ,
CONTRACTOR
Name Justin Navin
Name: Roderick Waller
Address: 5817 Sunberry CIR
Company: Sunrise City CHDO Inc.
City: Fort Pierce, FL State: FL
Address: 130 S Indian River Drive
Zip Code: 34951 Fax:
City: Fort Pierce State: FL
Phone No.
Zip Code: 34950 Fax: 772-907-0420
E-Mail:
Phone No. 772-201-2850
Fill imfee simple Title Holder on next page (if different
E-Mail: rodwallerl@gmail.com
from i he Owner listed above)
State or County License: CCC1327208
it value of construction is $Z5i)0 or more, a RECORDED Notice of Commencement is required.
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SUP=PLEMEIV "AtL CONSTRUCTION LIEN' L'AUU INaF0RMATION
:.
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY:
Q Not Applicable
Namel: Justin Navin
Name:
Address: 5817 SunberryCIR
Address: 6505 PENSACOLA RD, FORT PIERCE, FL
City: FortPierce, FL State:
City:
State:
Zip: Phone
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: 0 Not Applicable
BONDING COMPANY:
MNot Applicable
Name:
Name:
Address:
Address:
City:
City: I
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify1that 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
WARDING 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.
Signa ure of Owner/ Lessee Contractor as Agent for Owner
Signature of Co ractor/License Holder
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STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF St Lucie County
COUNTY OF St Lucie County
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The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 29nd day of October 20 18 by
I
this 29nd day of March 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
Typelof Identification
Type of Identification
Produced
Prod
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(Signlature of N tary Public- State of Florida)
(Signature of o F o ida
Commission
ice NotaryPublic
Commission N So H(��,'
arris
Notary Public State of Florida
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