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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Ig08 • Dla U
Date: 08/16/2019 Permit Number: 1808-0554 (RENEWAL)
Planning and Development Services
Building and Code Regulation Division -
2300 Virginia Avenue, Fort Pierce FL 34992
Phone: (772) 462-1553 Fax: (772) 462-1578
SCANNED
By
RECEIVED
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Building Permit Application
`-armitting Department
St. Lucie County
Commercial Residential X
PERMITTYPE: Drywall
PROPOSED INPROVEMENT LOCATION;, r,
Address: 312 Essex Dr. Fort Pierce FL 34946
Property Tax ID #: 1432-805-0042-000-7
Site Plan Name:
Project Name:
DRYWALL
Lot No. 42
Block No.
(REMOVAL AND INSTALLATION)
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator _
Total Sq. Ft of Construction:
Cost of Construction: $ $2,370.00
Windows/Doors
Roof Pitch
Sq. Ft. of First Floor: 1,374
Utilities: _Sewer _Septic Building Height: 12
Name CALVIN W. DIXON
Name: Roderick Waller
Address: 312 ESSEX DR.
Company: Sunrise City C. H. D. O. Inc.
City: FORT PIERCE State: _
Zip Code: 34946 Fax:
Phone No.
Address: 130 S. Indian River Dr. #202
City: Fort Pierce State: FL
Zip Code: 34950 Fax: 7729070420
Phone No 772-201-2850
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-MailRodwallerl@gmail.com
State or County License CGC1515114
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SU' lLEMtNTAL' CONSTLtUCTION LIEN LAW INFORMATI'Ot
- __
_ _ . I.
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
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 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 1 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
commencwR work or recording our Notice of Commencement.
WIA(A
Signatur4 of Owner/ Lessee/co tractor as Agent for Owner
Signature of Contractor/License Hol Yer
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 taSHday of AUGUST 26a by
this 18tH day of AUGUST 204 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
Produced2414;L
Produced
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(Signature of Notary Public -State of Florida)
(Signature of N tary Public- State of Florida )
Commission No. (Seal)
Commission No.
Nato Pubic State of Floods
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