HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/27/2016 Permit Number: �rog
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Building Permit Application
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 ,
PROP,OSED_[MPR QVEMENT';` I'ON `.
Address: 170 NE FLORESTA DR, Port St Lucie, FL 34983
Legal Description: RIVER PARK-UNIT 9-PART C BLK 81 LOT 2 (MAP 34/21S)(OR 3455-2575)
Property Tax ID#: 3419-570-0100-000-8 Lot No.
Site Plan Name: Block No.
Project Name: ReRoof
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION"OF WORK-
Re-Roof Sh o�'A�le- 7 S
r
CO`NSTRUCTIQ,N INFORMATION
,INFORM
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Additional work to be nertormed unclert is permit—checkallapply:HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator ,.Roof
Total Sq. Ft of Construction: 1580 S Ft.of First Floor: 1580
Cost of Construction:$ 7100.00 Utilities:Sewer[]Septic Building Height:
''0 'ERA
LESSEE
,CONTRACTOR. . rr
_.
Name Ramano Lopez Name: Roderick Waller
Address:170 NE FLORESTA DR, Company: Sunrise City CHDO
City: Port St Lucie, State:FL Address: 3550 Okeechobee Rd
Zip Code: 34983 Fax: City: Fort Pierce State:FL
Phone No. Zip Code: 34947 Fax: 772-907-0420
E-Mail: Phone No. 772-201-2850
Fill in fee simple Title Holder on next page(if different E-Mail: rodwaller1@gmail.com
from the Owner listed above) State or County License: CCC1327208
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
A
DESIGNER/ENGINEER: _Not Applicable 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: Address:
City: City:
Zip: Phone: Zip: Phone:
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 thepermit 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
comrpqncAng w rk or recording our Notice of Commencement.
MK 41-11 Afn 0 k Ww
s
_Signature oftRIDA
ner/Less Agent Signature of Con actor/License Holder
STATE OF FL STATE OF FLORIDA
COUNTY OF COUNTY OF S-I - Lod e
The fo going instrument was acknowledged before me The forgoing instrument was acknowledged before me
this��day of 20 Eby this7a-1 day of 20 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary P lic-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Prgduced Identificatio Personally Known OR Pruced I
Type of Identification Produced L Type of Identification Produc Np �,,,"�"CO2202�''
.,, r,OMM1SS bet 16.20'��
Commission No. 5 pj;� un020 ,� Commission No.� ''• � �rymubtloUnde^"fiteK
..�.�"�,.,, M� P�RESD ry�yRc en�`te :�; •o=� 8� P
ota
ner
Revised 07/15/201 •':'jg�v°a'' go
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS