HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I hh_'Inn
Date: 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: Roof
PROPOSED IMPROVEMENT-LOCATION:
Address: 716 NETTLES BLVD,JENSEN BEACH FL.. 34957
Legal Description: SEC:02 TWN : 37 S RANGE 41 E
Property Tax ID#: 4502-501-0902-000-4 Lot No.
Site Plan Name: Block No.
Project.Name: POEHLMAN RESIDENCE
Setbacks Front Back: Right Side: Left Side:
DETAILED DESGRIPTION_`OF WORK:
REMOVE EXISTING SHINGLED ROOF. INSTALL SOPREMA RESISTO SHINGLE .
UNDERLAYMENT DIRECT TO DECK. INSTALL IKO CAMBRIDGE SHINGLES PER CODE. .
2/12 PITCH
CON,,STRUCTION.INFORMATIO.N:
Additional Work to be nertormed under this permit—c ec a appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors .
Electric El Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 3,250.00 Utilities: Sewer ElSeptic Building Height: 15 FT.
01NN.ER/LESSEE CONTRACTOR:
Name NANCY POEHLMAN Name: GARY MARZO
Address:716 NETTLES BLVD Company: GARY MARZO,INC.
City: JENSEN BEACH State:FL Address: 861 A-SW LAKEHURST DRIVE
Zip Code: 34957 Fax: City: PORT ST. LUCIE State:FL.
Phone No.772-2291461 Zip Code: 34983 Fax: 772-465-8829
E-Mail: Phone No. 772-871-2489
Fill in fee simple Title Holder on next page(if different E-Mail: GMARZOINC@AOL.COM
from.the Owner listed above) State or County License: CC-C058193
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN IN.FQRMATION
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: Name:
Address: Address:
City: City:
Zip: Phone: 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 thepermit 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.
U Ms
_&gnatu�e of Ow a Lessee/Age t Signature oontr cto./Lrcense H I er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST.LUCIE COUNTY OF ST.LUCIE
The forgoing instrument bt was acknowledge fore me The forgoing instrument was acknowledged before me
this Re day of OST kt/' 20 ID by this 16 day of OCTOBER 20 L by
DAVID VANDERRIER DAVID VANDERFLIER
(Name of person ac no edgin (Name of person acknowledging)
�i
(Signature of plotary publii-State of Florida) (Signature iif ly'ary�.Public-State of Florida)
Personally Know x I Ica I�onPersonally Known x on
T e of Identifica ii t � VID VANDERF '
Type Type of Identification P Ud}a , DAVID VANDERFCfER
MY COMMISSION#FF099550 `• MY COMMISSION#FF099550
Commission No. 'e¢' =YP1RF_S(k%W0h 9,2018 Commission No. = Q ExpItfeslMarch 9,2018
(407)39M153 FlorldaWta SeNICe.Com (407)398-0153 FloridallotaryService.com
Revised 07/15/2014
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