HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 171— Permit Number: I (0riA iim
��
win
- - - -
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: 2025 Hugo Rd
Legal Description: SAN LUCIE PLAZA S/D-UNIT ONE-BLK 1C(2025,2031 HUGO RD)ALL
ALL LOT 8 AND E 22 FT OF LOT 9-LESS S 20 FT-(MAP 14/33N) (OR 2088-2782)
Property Tax ID#: 1428-702-0010-000-5 Lot No.
Site Plan Name: Noelke Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
� 'bET'A"IL"ED',,''DE"S"'C'RIPTION"OF.WORK: -
Tear off shingle roof Install Peel and stick and 5 v metal roof
5 V Crimp FI 17022-R6 Tri Built Peel and stick FI 16048-R3
CONSTRUCTION INFORMATION:,
Additional work to be nertormed under this permit—check a app y:
11HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing OSprinklers E Generator V Roof
Total Sq. Ft of Construction: 2500 S Ft.of First Floor:
Cost of Construction:$ 8850.00 Utilities: _Sewer E]Septic Building Height: 15
OWNER/LESSEE: CONTRACTOR: ,
Name Joe and Gina Noelke LLC Name: Richard A. Ne land'•
Address:480 River Prado Company: Richie the Roofer
City: Fort Pierce, State:FL Address: 6704 Santa Clara Blvd
Zip Code: 34946 Fax.216-0259 City: Fort Pierce State:FL
Phone No.772-321-5951 Zip Code: 34951 Fax: 866-610-8652
E-Mail: Phone No. 772-464-4329
Fill in fee simple Title Holder on next page(if different E-Mail: richieroofer@yahoo.com
from the Owner listed above) State or County License: CCC058021
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I
I
i
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.-
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 st sw 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
ignature of Owner/Lessee/Agent Si ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 7SAt.I1a COUNTY OF w l
The f rgoing instrument was acknowledged before me The f going instrume t was acknowledged before me
this day of - g_ 20�by this day of 20 L by
1\ '
(N a of person acknowledging) (Name of person acknowledging)
ig ature of Notary Public-Stt of Florida) (Stgna re of Notary Public-St of Florida)
Personally Known d�eedldentification= Personally Known a tif'cation
Type of Identificati Pg""d LASHAHNA INGRAM Type of Identification "�"��,
; •; Notary Public-State oFlorida ?,
Commission No. -•: _ M Comm es Dec 20,201ti ? ' , •,� No Pu lic-SJFr�f (`�g19 Commission No. .•;MY(( I Commission FF 177249 xpiresocFLo? Commission,#gonad !hro,,Q)1•I;ling3l Wary A.3n. " "' Bonde
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS