HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9-14-2017 Permit Number:M ffim 6311:6_�'-W_
I 1
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: 2524 Seneca Ave
Legal Description: San Lucie Plaza S/D-Unit one-BLK1 D(2524,2530 Seneca AV)S 20 ft Lot 17,All L0t18 AND N 18 FT LOT19
(MAP14/33N) (OR 2088-2773)
Property Tax ID#: 1428-702-0022-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Tear off existing shingle roof and install 5 v crimp metal roof FI 17022-R6 and Peel and stick
FL16048-R3 Ol a
CONSTRUCTION INFORMATION:
Additionalwork to e Qerformed under this permit—check all that apply:
E1HVAC Gas Tank Gas Piping _Shutters Q windows/Doors
11 Electric 1:1 Plumbing Sprinklers Generator F] Roof
Total Sq. Ft of Construction: 2500 S Ft.of First Floor:
Cost of Construction:$ 8850.00 Utilities:nSewer 0Septic Building Height: 15'
.OWNER/LESSEE: ' CONTRACTOR: .
Name Dennise J Noelke Llc Name: Richard A. Newland
Address: 5305 Deer Run Company: Richie the Roofer
City: Fort-Pierce State:FL Address: 905 13th st sw
Zip Code: 34951 Fax: City: Vero Beach State:FL
Phone No.772-216-5125 Zip Code: 32962 Fax: 866-610-8652
E-Mail: Q 1A Phone No. 772-464-4329
Fill in fee simple Title Holder on next page(if different E-Mail: dchieroofer@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.
MOW
SUPPLENIEWAL CONSTRUCTION LIEN LAW IN 0R.MATION
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: RichardANewland Name:
Address: 905 13th stsw Address:
City: Vero Beach City:
Zip: 32962 Phone: 772-473-6197 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 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.
s
_Signature of Owner/Lessee/Agent Si a of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA Q
COUNTY OF L�_Q� COUNTY OF G1
The f oing instrument was cknowledge re me The for oing instru ent was cknowledged ore me
s day of 20 L thi ray of 20 y
(Name of person acknowledging) (Na k edging}
(Sign atur ary P blic-State of Florida) (Si ur ublic- tate of Florida}
Personally Known OR Produced Identification Personally Known OR Produced Identification
T e i ication Produced io mdlu-e _
,�4PRV P !i �--
Commission No. (Seal) a Commission No. ��_°• ae`�, Notary pub -Scat F +
�� =• m ` y c State of Florida
;� I YPll,, ANGELA M HUFF Commission#
FF234730
Notary Pubic State ot Florion,� +� May 2 10)J
Commission#FF 234730 Bonded through VationalNota7 20 f(f(�
Revised 04 ryAssn. '
> My Comm.Expires May 27,2015
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