HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (�
Date: �' ar7-��g�n���(��`� Permit Number: 7n 5 0 1(U 1
- RECEIVED
Building Permit Application
Planning and Development Services MAY 3 12018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 3982 ST. Lucie County, Permitting
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR:I To Select from dropbox, click arrow at the end of line
PROPOSED I..MPROVEME 'NT 4COCATLC?N
Address: a�)D,b ('a. Ay.
Legal Description: �Qft, ('� 9� ]a-L-a — '_:� Wa4.1 '-Uj�
CON87, RPCTIt7N INFORMATION
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a a apply: worktoeom
11HVAC " Gas Tank Gas Piping _ Shutters ❑ Windows/Doors
11 Electric ❑IPlumbing 11 Sprinklers 1i Generator Fv—(] Roof
Total Sq. Ft of Construction:
Q-�� S . Ft. of First Floor:
Cost of Construction: $ ,1 ' Utilities:n Sewer E]Septic Building Height:
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`01NNER/L.ESSEE .,.
CONTRACTOR
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Name Dennis J Noelke LLC
Name: Richard A. Newland
Address: 5305 ;Deer R l n Dr
Company: Richie the Roofer
City: Fort Pierce State: F1
Zip Code: 34951 Fax:
Phone No.
Address: 905 S 13 St
City: Vero Beach State: FI
Zip Code: 32962 Fax:
Phone No. 772-473-6197
E-Mail:
Fill in fee simple Tile Holder on next page (if different
from the Owner listed above)
E-Mail: richieroofer@yahoo.com
State or County License: CCC058021
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
S'UPPLEME�NTAL CON5TRUCTIO�N LIEN LAIN
1NFQRMATIQN
DESIGNER/ENGINEER:
Name:
_ I�ot Applicable
I
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
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Address:
City: State:
Zip: Phone:
City: I State:
Zip: Phone: I
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
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BONDING COMPANY: Not Applicable
Name:
Address:
I
Address:
City:
City: I
Zip: Phone:
I
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no represental:ion 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 116 me 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. IfJyou intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
5ignature of Owner/ Lessee/
STATE OF FLORIDA
CO U NTY OF sT Lucie
The forgoing instrument was
this _ day of
1 1
(Name of person acknowledging )
edged before me
20 _by
ature of Notary Public; State of Florida )
Personally Known.
Type of Identificati
Commission
Revised 07/15/2014
re of Contractor/License Holder
STATE OF FLORIDA
CO U NTY OF St LuC1e
The forgoing instrument was acknowledged before me
this day of , 20 _by
hjo� IUD lam
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
'it!# M$E 6lmrida Personally Known
a P Sanderson Type of Identification r . , , ,
n lissi 2022 . Ama• ~a P Sanderson
Commission No. Sky C. ' 72I32: g� � 2+1256
r EXOIreb C)a"L
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FRONT
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INITIALS
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