HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONf
ALL APPLICABLE INFO MUST BE COMPLETru:FOR APPLICATION TO.BE ACCEPTED
Date:! D�� �r�t��� _ Permit Number:
Al
ItECI?it11E®
Building Permit Application
MAY-.0,2018-
Planning and Development:Services .:
P9rfnitting Department
.'St. Lucie County
Building. and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ....
Phone: .(772) 462=1553 Fax;. (772) 462-1578 „CoI7 me,rcial :Residential xxx
PERMIT APPLICATION FOR:: To Select:from dropbox, .click arrow at the end of line.
PROPOSED IMPROVEMENT LOCATION: ;-
Address 4625 S INDIAN RIVER: D.R I
Legal Description: 36 35 40 N 235.9 FT OF S 1323.3 FT OF GOVT LOT 2 LYG .E OF FEC-LESS RD. RNV- (34). (OR 595-364.)
Property Tax ID #: ID: 2436-331-0001.-000-9 I
Site Plan Name: Flat roof. repair I
Project Name:
i.
Setbacks . Front Back: Right Side:
...Lot No. . .
Block No. .
Left Side:
-.DETAILED-DESCRIPTION OF WORK:_ ; -
Repair flat roof - 300-400 sq. ft: Tribuilt Modified - FL 16027 APP-TA base -smooth
APP-TA .cap- smooth
CONSTRUCTION 1 RMATION
Additi.onal wor to e erto.rmeunder this permit — c o ec
❑Gas Pliping
all
apply:
Windows/Doors
HVAC
Tank:
:
_Shutters
,
_Gas
Electric 0Plumbing
OSprinklers
Generator
Roof Roof pitch
Total Sq. Ft of Construction: 300 sq_ ft. .....
S : Ft. of First Floor:
Cost of Construction: $ 2000
....
Utilities: _Sewer
_Septic
. gHeight:.
Building
DVI/NER/LESSEE: i
CONTRACTOR: "
Name... y
Henr �A Salzler "" "' ""'
Name: RAY VILLANOVA
Company:. VILLANOVA CONSTRUCTION INC.
,Address:: S Indian River Dr I
City: Fort_Pierce, FL.34982 State::Fl�_
Address:.2908 Oleander Blvd.
34982
Zip Code: Fax:
Ft. PIERCE FL
City. State:
Phone No. 772-332-4306. I
Zip Code: 34982 Fax:
Phone No. 772-940-6654..
E-Mail: rayvillana)aol.com
E-Mail:
:Fill. in fee simple Title Holder on next page. ( if different
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,LIEN LAW.INFORMATION:
.DESIGNER/ENGINEER: ^ Not Applicable. MORTGAGE COMPANY: _ Not Applicable -
Name: :..: Name:
Address: - I Address:
City State: City.: State:
Zip: Phone: .. Zip: ... Phone:
FEE SIMPLE TITLE. HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: I -Address:
City: I City:
Zip: Phone: Z'ip: Phone:
�... .
I certify that no work or installation has ,commenced prior to the issuance. of a permit:
St. Lucie Countyyict with any applicable Home Ownermakes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in 0 trs 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 dermit, 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, waAi,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 your. Notice of..Commencement.
s
Signature of ner/Lessee/Contractor as Agent or Owner Signat a of Contractor/License Holder
STATE OF FLORIDA. STATE OF FLORIDA
COUNTY OF. St.Lucie COUNTY OF St.Lucie_
4
e{ The forgo' g instrum nt was acknowledged before me
The forgoing instrument was acknowledgedefore
this "S day of May 20 1 by. = •:A� this Ai day of 20 18 by
1 .
H
(Name of person acknowledgin ,) _
a
(Name of person acknowledging
rn
co
m......
(Signature of Notary Publi-;-State of Florida )
Personally Known OR Produced Identif
Type &.Identification Produced
Commission No. (Seal).
Revised 07/15/2014
r (Signature of Notary Public- State of Florida )
Personally Known �OR Produced Identification
'Type of,identification Produced
Commission No.
(Seal)
REVIEWS
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SUPERVISOR:
PLANS"
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS,