HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 - 3o - I Permit Number:
\pC,-, SC ��fey RECEIVED
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Building &Wt�Application MAY 3 12018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select f tom dropbox, click arrow at the end of line
PROPOSI DD I`M ROUEM'ENT LOCATION
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Address: a �- n I I� ace-�
Legal Description: ZGL -
Property Tax ID #J Y -7b -9, -O sb l; OOb- Lot No.
Site Plan Name: I Block No.
Project Name: I
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Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIkPTION OF WORK r
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°;CONSTRUCTION INFORMATION
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Additionalwork to a er orme " under this permit - check a apply:
EIHVAC Ei Gas Tank []Gas Piping _ Shutters 0 Windows/Doors
11 Electric ❑ Plumbing Sprinkl:ilities:cn
IGenerator W1 Roof
Total Sq. Ft of Construction:}, � CCo S of First Floor:
Cost of Construction: $ R� bg=a Sewer OSeptic Building Height:
OWNER/LESSEE
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CONTRACTOR,
Name Dennis J Noelke LLC
Name: Richard A. Newland
Address: 5305 Deer Run Dr
Company: Richie the Roofer
City: Fort Pierce State: Fl
Zip Code: 34951 Fax:
Phone No.
E-Mail:
Address: 905 S 13 St
City: Vero Beach State: FI
Zip Code: 32962 Fax:
Phone No. 772-473-6197
Fill in fee simple Title Holder on next page ( if different `
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from the Owner listed above) 1
E-Mail: richieroofer@yahoo.com
State or County License: CCCO58021
11 vasuc ui wnxruLavn is ?cauu or more, a ntcunutu rvonce of commencement is required.
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S:UPPLEMEIVTAL CONSTRUCTION LIEN= LAW INFORMA?[C1N
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone:
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Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address: I
Address:
City: I
City:
Zip: Phone: I
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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.
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_ Signature of Owner/ Lessee/Agent `�
ignature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
CO U NTY OF ST Luaie
CO U NTY OF St Lucie
The r instru nt was acknowledge fore me
thi day of 20 by
The forgoing instrument was acknowledggd�fore me
this (Sr'd'ay of 20 l by
I, ukAJ U" �
�1'0_ho 1
(Name of person acknowledging)
�
(Name of person acknowledging )
ignature of Notary Public- S e of Florida)
(Signature of Notary Public- State of Florida )
Personally Known a i i
Personally Known FT
Type of Identification O Notary Public State of Flon
Type of Identification Pr Notary Public State of Flo i
mac.
�vty Commission GG 211256
Commission No. Jfdcpiraso22
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Amanda P Sanili8mon
My corms n GG 21126B
Commission Nd+.J1,� I Expiresl�¢7gg22
Revised 07/15/2014 I
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
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INITIALS
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