HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3\ Permit Number: \6%rJS—OT 9
Building Permit Application
Planning and Development services MAY 3 1 2019
Building and Code Regulation Division
2300 Virginia Avenue, FortPierce FL 34982 LST.cie County, Permitting
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X "®
PERMIT APPLICATION FOR: Other C111-ma •e 6� 0CC U^Acv III
Address: 160 SE Celestia Ct., Port St Lucie FL 34983
Legal Description: RIVER PARK -UNIT 5 BLK 46 LOT 6 (MAP 34/28N)
PropertyTax ID #: 3419-540-0110-000-8
Site Plan Name:
Project Name: Occupancy Change
Setbacks Front Back:
I" DETAILED' DESCRIPTION OF WORK_
Right Side:
APD grup home w/ occupancy for 5 residents
Left Side:
Lot No.
Block No.
14'CONSTRUCTION,INFORMATION:, , III
E1HVAC Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction: 72120
Cost of Construction: $ 500.00
mc— cnecxau apply:
Piping Shutters ❑Windows/Doors
ars 0 Generator 11 Roof Roof pitch
S Ft. of First Floor: 1485
Utilities:nSewer0Septic Building Height: 8
OWNER/LESSEE,;:
CONTRACTOR:`
Name McNair Empire LLC
Name: Roderick Waller
Address:5259 NW South Lovett CIR
Company: Sunrise City CHDO Inc.
City: Port St Lucie State: FL
Zip Code: 34986 Fax:
Phone No. 2 I S
Address: 103 S Indian River Drive, suite 202
City: Fort Pierce State: FL
Zip Code: 34950 Fax: 772-907-0420
Phone No. 772-201-2850
E-Mail: 1"y_A1o1r =wtD:rP e
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: rodwallerl@gmail.com
State or County License: CGC1515114
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
F-
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CBS Sid
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-SUPPLEMENTAL CONSTRUCTION! LIEN LAUV INFORMATION:
_
DESIGNER/ENGINEER: Q Not Applicable
MORTGAGE COMPANY: Q Not Applicable
N am e: Wayne Goody
Name:
Address:
Address:
City: Orlando State: FL
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: 0 Not Applicable
BONDING COMPANY: QNot 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
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
commencingwork o11r renncofnJr--din our Notice of Commence ent.
L4) a"/-'
Signature of Ow er/ Lessee/Contractor as Agent for Owner
n _
Signature of Contra for/License Holder
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 30nd day of May 2019 by
this 30nd day of May 2019 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
Type of Identification
Type of Identification
Produced
Produced
j1 n
j
(Signature ofNotary Public -State of Florida)
(Signature o Notary Public -State of Florida-)
FWrida
Commission No. Nob(6F S of
Commission No. NotWy Public Sophia Haft of FloridaMy "orriM �aion GG 236873
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA L
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17