HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/15/18 Permit Number:
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 6502 Donlon Road, Ft.Pierce Fl 34951
Legal Description: Lakewood Park -Unit 10 BLK 135 LOT 6 (Mao 131015) (OR 3952-858
Property Tax ID #: 1301-612-0407-000-9
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Lot No._
Block No.
OWNER/LESSEE: CONTRACTOR:
Name Jennifer Wilson Name: Richard A. Newland
Address: 3943 Victoria Dr Company: Richie the Roofer
City: West Palm Beach State: FL Address: 905 13th st sw
Zip Code: 33406 Fax: City: Vero Beach State: FL
Phone No. li Zip Cone: 32962 Fax: 866-610-8652
E -Mail: Phone No. 772-464-4329
Fill in fee simple Title Holder on next page I if different E -Mail: richieroofer@yahoo.com
from the Owner listed above) State or County License: CGC 1512738
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRtJCTI(?N LIEN LAIN INFQRMATtN>
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: Richard A Newland
Name:
Address: 905 13th stsw
Address:
City: Vera Beach
City:
Zip: 32852 Phone: 7721+73-6197
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 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 wM, 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 your Notice of Commencement.
s' Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OFsamtL�ee
The fore�� v4i��
edged,{� fore me
this `day 20 by
_7� i
of person acknowledging j
gnature of Notary Public- State
Personaffy Known x OR Produced Identification
Type of Identification Produced
Commission No. GG211256
Notary Pubfic,State of
wci ave f
fa My Commission GG 211256
Revised 07/15/201 a Expires 04/2542022
REVIEWS FRONT I ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
Contractor/License Holder
STATE OF FLORIDA
COUNTY OF saint Lucie
The forgoing instr ment was Icknowiedged before me
this 1 day of 20 t by
(Name of person acknowledging )
{Signature of Notary Public- State of Florida j
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. GG2
i Notary Public State of Florida
Ely L_ � IMtseron GG211256
Expires 04/25/2022 .
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