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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION Date: Mar. 21, 2018 0 Building Permit Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Comm BE ACCEPTED Permit Number: 1� RECEIVED pplication MAR 2 6 2018 LIT. Lucie County, Permitting I Residential xxx PERMIT APPLICATION FOR: To Select from dropbox,1 click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: 903 Seminole Dr. Legal Description: Sorora Grove, Lots 13 & 14 Property Tax ID #: 3409-802-0013-000-0 Site Plan Name: Seminole Drive Project Name: Setbacks Front Back: Right Side: Left Side: Lot No. Block No. DETAILED DESCRIPTION OF WORK: I I Remove shingles, Install 5 V Crimp.. _ . .'970L Underlayment FL 16048 Tri-Built CONSTRUCTION INFORMATION: Additional work to e e 1JHVAC E] ormed under this permit— check ❑Gas all apply: Shutters Q Windows/Doors Gas Tank Piping _ Electric 0 Plumbing Sprinklers Generator R]Roof 4/12 Roof pitch Total Sq. Ft of Construction: ;, 8 0 0 S . Ft. of First Floor: 9000 Cost of Construction: $ Utilities: W i Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Arley Hatch Address: 903 Seminole Rd. City: FT. PIERCE State: FL Zip Code: 34982 Fax: Phone No. E-Mail: Name: Company: Address: City; Zip Phone E-Mail: St Ray Villanova VILLANOVA CONSTRUCTION INC. 2908 OLEANDER BLVD. FT. PIERCE State: FL Code: 34982 Fax: No. 772-940-6654 rayvillan@aol.com Fill in fee simple Title Holder on next page (if different from the Owner listed above) to or County License: CCC 1327240 If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirea. 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: Name: Address:_ — - Address: City: City: Zip, Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issua i ce 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 roorrls and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Corr mencement 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 commencine work or recording our Notice of Commencement. Signat a of Owner/ Lessee/Contractor as Agent for Owner Sig 'a re of Contractor/License Holder STATE OF FLORIDA ST:TE OF FLORIDA COUNTY OF ST. LUCIE CO NTY OF ST. LUCIE The forgoing instrument was acknowledge efore me The forgoing instrument was acknowledged before me thisdQU day of MARCH 2O by this 21 day of MARCH 20_ by V 11F Rim M-0 1�3 D k Name of person making statement / Name of person m king statement Personally Known OR Produced Identification Personally Type Known _R Produced Identification of Identification Type of Identification I Produced V Produced Xg Al (Signature of Notary Public- State of Florida) (Signature of Notary Pub l - Sta o , , c1! I IRLEY I(. E ENDERFER # FF 91l9655 Commission No. """"'�� $EIM R E N S . N I E L S E ,. nY ,�8,, 1'.- 'CoCO om ssiay fission No. � -� �E�p�� May 8, 2020 Commission FF 1156 '" 7 ,`,,, � Bonded ThruTroyFain Insurance l0 p4 i My Commission Expir s hine 12. 2018 nnn REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17