HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 11/19/2018 Permit Number: L-'�l '<� DJ" /� ISO
Building Permit Application RECEIVE®
Planning and Development Services Nov 1' 9 2019
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Permitting Department
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residentia`i`epunty
PERMIT APPLICATION FOR: Roof SCANNED
(?f20POSED I,IVIPROVEM'ENT LOCATICN�°
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Legal' Description: 31 34 40 BEG 98 FT S AND 110 FT E of NW COR of SEC RUN E 200 FT TH S 265 FT TH E 14
FT TH S 182.5 FT TH W 145 FT TH S 14.6 FT TH W 200 FT TH N 462.1 FT TO POB
Property Tax ID #: 1431-222-0003-000-0 Lot No.
Site Plan Name: Block No.
Project Name: RE - ROOF
Setbacks Front Back: Right Side: Left Side:
RE -ROOF SHINGLE TO METAL
CONSfTRUCTIQN INFORMATION
Additionalwork to be
11HVAC
nertormed
L_J
Gas Tank
under this permit — check a
E] Gas Piping
t apply:
Shutters
a Windows/Doors
ElElectric
Plumbing
Sprinklers
E
Generator
Z
Roof
3/ 2 ]
Roof pitch
Total Sq. Ft of Construction: 2,058
Cost of Construction: $bT�JCQ,
Sq. Ft. of First Floor:
Utilities: Sewer Septic Building Height:
01IUNER/LESSEE
�„
C " NTRACTOR. ,' a
Namel KF LLLC
Name: RODERICK J WALLLER
Address: 13520 BARRY ST
Company: SUNRISE CITY C. H .D .O. INC.
City: HOLLAND State: MI
Address: 130 S INDIAN RIVER DR. #202
Zip Code: 49424 Fax:
City: FORT PIERCE State: FL
Phone; No.
Zip Code: 34950 Fax: 772-907-0420
E-Mail:
Phone No. 772-201-2850
E-Mail: RODWALLER1 @GMAIL.COM
Fill in fee simple Title Holder on next page ( if different
State or County License: CCC1327208
from the Owner listed above)
It value, of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL
CONSTRUCTygION LIEN LAW INFORMATION
DESIGNER/ENGINEER: _
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY:
Not Applicable
_
Name:
Name:.
Address: 130 S INDIAN RIVER DR. #202
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
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 your Notice of Commencement.
V�C r � CIO`'U&�__
Signature of Owner/ Lesse /Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The forgoing instrument was acknowledged -before me
this 19TH day of NOVEMBER 20Ig by
RODERICK J WALLER
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No.
REVIiEWS
RECEIVED
DATE'
COMPLETED
Rev.8/2/17
o Not9ry Pubk Stele of Florida
Sophia Hems
u . My Gommiasion GG 238873
FRON?Q
COUNTER I REVIEW I REVIEW
of Contractor/fticense Holder
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The forgoing instrument was acknowledgbefore me
this 19TH day of NOVEMBER 120!8 by
RODERICK J WALLER
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
(SjgniatdYeOf Notary Public- State of Florida )
mmission No.
Publk SteEa Of Fbrida
9 Harris
'PLANS VEGETA OhS�RO
REVIEW I REVIEW REVIEW REVIEW