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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date..L.11- IV 9GANNED Permit Number: r O
s:_ � -�; -� � :� �� St eels Cou ntv
�/ RECEIVED!
Building Permit Application
Planning and Development Services ii MAY
Building and Code Regulation Division ST. 6ucie County, Perrnittiei ,
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XXXX
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I
PROPOSED IMPROVEMENT LOCATION:
Address: % .6 % /\J -3. 7 447 S
Legal Description. WILBUWE BLK 1 LOT 7-LESS W 16 FT- AND S 40 FT LOT 8-
Property Tax ID #: 2408-603-0006-000-1
Site Plan Name:
Project Name: 3 V
Setbacks Front Back:
Right Side: I Left Side:
Lot No.
Block No.
DETAILED., --DESCRIPTION OF WORK:
_ ` J�Z. / b
5 11
— _S' S l 6 v--
`CONSTRU'CTIONINFORMATION: t
itional wor c-to be ertormed under this permit —check all apply:
11HVAC
LJ Gas Tank
❑Gas Piping
L l Shutters
Electric
El Plumbing
Sprinklers
F]Generator
Total Sq. Ft of Construction: 3000 SQ FT S . Ft. of First Floor:
Cost of Construction: $ 10000 Utilities:cn Sewer E]Septic
QWindows/Doors
91 Roof Roof pitch
Building Height:
NER/LESSEE: :....
CONTRACTOR:
Name LEWIS MC CRAY
Name: RAY VILLANOVA
Address: 101 N. 37TH STREET
Company: VILLANOVA CONSTRUCTION INC.
City: FT, PIERCE State:FL
Address: •2908 OLEANDER BLD
Zip Code: 34947 Fax:
City: FT. PIERCE State: FL
Phone No.772 216 6214
Zip Code: 34982 Fax:
E-Mail:
Phone No. 772 940 6654
Fill in fee simple Title Holder on next page ( if different
E-Mail: rayvillan@aol.co.
from the Owner listed above)
State or County License: CCC 1327240
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIE
LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name.
Address:
City: Stater
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: Name:_
Address: •2908 OLEANDER BLD Address:
City: City:_
Zip: Phone: Zip:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City:' State:
Zip: Phone:
BONDING COMPANY: Not Applicable
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 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 f ITundergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, sig i s, 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 vour Notice of Commencement.
Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The for oing instrument was acknowledged -before me 1
this If day of 20 by
Name of persop making statement
Personally Known �� OR Produced Identification
Type of Identification
Produced
re of NoQQ Public- State of Florida )
Commission No o _ f Florida-NotarLSEN
y PU blic
3. ._
Per Commission.# GG 207hgq
T„�� My COrnm153ion Fv„;.....
REVIEWS I FRONT ws
CO NTER I ROEVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
Signature#f Contractor/License HolBer
STATE OF FLORIDA
COUNTY OF Ade
The forgoing instrument was acknowledge efore me
this / day of tM141-1 , 20IJ by
' B
ame of peryn inaking statement
Personally Known t, OR Produced Identification
Type of Identification
(Signature of Notary Public- State of Florida )
Commission No.
PLANS I VEGETATI
REVIEW REVIEW
State Of °f F
Coorida NIELSE
Y Corn,,, _ GG 2n-j,