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
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Commission FF 1156
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My Commission Expir
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17