HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I Q - 00 W
Date: 0410212019 SCANNED Permit Num e
BY v
' St. Lucie County
Building Permit Applicatio APR 2 2019
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
�.PROPOS_ED IMP.ROVEIVIENT LQCATION;_ 7
Address: 3008 AVE R, Fort Pierce, FL 34947
Legal Description: SUNRISE PARK NO 1 BLK 3 LOT 13 (0.17 AC) (OR 3722 - 2433)
Property Tax ID #: 2405-501-0060-000-5 Lot No. 13
Site Plan Name: Block No. 3
Project Name: RE - ROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF.WORK
�i ytp' RE -ROOF SHINGLE TO METAL
CONSTRUCTION INFORMATI(jN:
itional work to be oerformed under tispermit—check all apply
OHVAC Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction: 1,176
Cost of Construction: $ 4,650.
❑
Gas Piping
_
Shutters
Windows/Doors
]Sprinklers
0
Generator
R1
Roof
3/12
Roof pitch
S Ft. of First Floor: 1,176
Litilities:Sewer0Septic Building Height: 11
OWNER%LESSEE:.
CC) NTRACTOR: ` .
NameCHARLES G. BROWN/CHARITY E. BROWN
Name: RODERICK J WALLLER
Address: 3008 AVENUE R
Company: SUNRISE CITY C. H .D .0. INC.
City: FORT PIERCE State: FL
Zip Code: 34947 Fax:
Phone No.
Address:
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
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPFLEMENTALCONSTRUCTIQN LIEN LAW-INF.QRMATION
,
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
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
which is in conrict 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 our Notice of Commencement.
C
I
Signa ure of Owner/ Lesse /Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTYOF ST.LUCIE
COUNTYOF ST.LUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 2nd day of APRIL 20— by
this end day of APRIL 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 Identification
Produced
Produced
(Signature of hotary Public -State of Florida )
(Signature of N tary Public -State of Florida)
Commission No. 05/30/2020
ission No. 05/30/2020 ysrryr Sae
Notary Public State d F
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REVIEWS
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VEGETATION
SEATURTLE
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REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17