HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONN'
ALL APPLICABLE.INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11_y9l2611r, / - Permit Num
Building Permit Applicati
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
DECEIVED
JAN 17 2019
Permitting Department
St, Lu . County, FL
PERMIT APPLICATION FOR: Roof III
Address: 4305 Evergreen Ave, Fort Pierce, FL
Legal Description: MELISSIA MEADOWS BLK 5 FROM NW COR BLK 5 S 89 DEG 46 MIN E ALG N LI BLK 5 345
FOR POB THCONT S 89 DEG 46 MIN E 125 FT TONE COR BLK 5, TH S 00 DEG 01 MIN E AL G E LI BLK 5 38
Property Tax ID H: 2406-501-0048-030-7
Site Plan Name:
Project Name: RE - ROOF
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
St. Lucie
I`DETAILED.DESCRIPTION;OF`'WORK
n r
RE -ROOF SHINGLE P�i1)� y UNDERLAYMENT: PEEL & STICK 00W -3 Z,SQ
FIW &f 4 SR FI_ 14S'V Paz
CONSTRUCTI0N,INFORMATION .."
itiona wor to eQe orme un ert ispermit—c ec a appy:
LJHVAC LJ Gas Tank
11 Electric El Plumbing
Total Sq. Ft of Construction: 1,895
Cost of Construction: $ 7,350.00
Sas Piping _ Shutters ❑ Windows/Doors
Sprinklers Generator Roof 3/12 Roof pitch
S Ft. of First Floor: 1,895
Utilities:cnSewer Ll Septic Building Height: 11
_OWNER/LESSEE:' '`W m;
CONTRACTOR ''-
NameMICHAEL L. McKINNON Jr. ETAL
Name: RODERICKJ WALLLER
Address: 4305 EVERGREEN AVE
Company: SUNRISE CITY C. H.D.O. INC.
City: FORT PIERCE State: FL
Zip Code: 34950 Fax:
Phone No.
Address: 130 S INDIAN RIVER DR. #202
City: FORT PIERCE State: FL
Zip Code: 34950 Fax: 772-907-0420
Phone No. 772-201-2850
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: RODWALLERI @GMAIL.COM
State or County License: CCC1327208
IT value or construction is 4iZ50D or more, a RECORDED Notice of Commencement is required.
..���INGn/ GIN uaim ccrc: _ INDt HppucaDle MORTGAGE COMPANY: _ Not Applicable
Name: Name:
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 1 Address:
Zip: Phone: I 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.
Signature o Owne Lessee/Contractor as Agent for Owner
SignafurdycT Con Tctor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST. LUCIE
COUNTY OF ST. LUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 15TH day of JANUARY . 20_ by
this 15TH day of JANUARY . 20_ by
RODERICK J WALLER
RODERICK J 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 Identi
Produced
Produced ar
etey�pup�-y�-of Flpnrle
hfa Harris
2x�I �M�
.ommheion GG 20ae73
w rea OS/JU@0
(Signature of Not ry Public- State of Florida)
(Signature o Notary Public- tote o F o I
Commission No. 05130/2020 (Seal)
o mission No. 05/30/2020 (Seal)
Oar NotaryPudic SIa03 of F
+P hia Harris
�f My
Ea
4mmission
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P S
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COMPLETED
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Rev.8/2/17