HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED — O
Date: SUANNC® Permit Number:
R
BY
St. LuaieCounty �uN.o 5 tall
Building Permit Application Pern"Wng.ceceuntyen!
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 Residential X
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 205 SE ABETO LN, Port St Lucie FL 34983
Legal Description: RIVER PARK -UNIT 5 ELK 49 LOT 23 (MAP 34/28N) (OR 404
PropertyTax ID #: 3419-540-0224-000-0
Site Plan Name:
Project Name: RE -Roof
Setbacks Front Back:
'DETAILED DESCRIPTION,OF WORK:'
Right Side: Left Side:
Re -Roof (remove old shingles and install 5v metal) Product approvals
CONSTRUCTION INFORMATION:
LJHVAC LJ Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction: 1012
Cost of Construction: $ 8,000.00
Lot No.
Block No.
jerrmr— CnecKall
apply:
❑Windows/Doors
3asPilz
_Shutters
Sprinklers
1:1
Generator
Z
Roof
3/12
Roof pitch
S�Ft.I of First Floor: 1012
Utilities: nSewer Septic Building Height: 8
OWN ER/LESSEE:
CONTRACTOR: _.
Name 205 SE Abeto Lane Land Trust
Name: Roderick Waller
Address: 7700 Congress AVE Ste 3105
Company: Sunrise City CHDO Inc.
City: Boca Raton State: FL
Zip Code: 33487 Fax:
Phone No.
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:
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
IT value or construction is>z5uu or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Q Not Applicable MORTGAGE COMPANY: ✓Q Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: 0 Not Applicable BONDING COMPANY: ✓ LNot Applicable
Name:- mama• _
Na a ress: I Address:
City: City:_
Zip: Phone: Zip:
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 Count 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 our Notice of Commencement.
Al'
COk
Signature of Owner/ Lessee ontractor as Agent for Owner
Signature of Contractor/Lice se 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 6th day of June . 2019 by
this 6th day of June 20 19 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
Prod
Produced
ik
C
(Signature of r I' -
(Signature of %Lary Public- State of Florida)
Commission tmhry tea
Commission No.
My Conwn�GG 236973
Nodry Public State of Fkxitle
Harris
4EmliviiSophia
My C M!n43ian GG 238873
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGE
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COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17