HomeMy WebLinkAboutBuilding Permit Application 1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: JUNE 7, 2016 - Permit Number:
- RECEIVrp JUN 0 7 2016
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, xxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSE D.IMPROVEME:NTL'OCATION
Address: 5264 MARGARET ANN LN
Legal Description: GREEN ACRES SID BLK 3 LOT 7 (OR 1983-1972)
Property Tax ID#: 1430-700-0032-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: :- Right Side: Left Side:
.DETAILED DESCRIPTION OF WORK: e
REMOVE SHINGLE ROOF UNDERLAYMENT - TRIBUILT FL 16027
iNSTALL GAF SHINGLES FL10124
3/12 PITCH
CONSTRUCTION INFORMATION:-_' ,..
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Additional work toe nertormed un er t is permit—check a appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator xx Roof
Total Sq. Ft of Construction: 1400 S Ft.of First Floor:
Cost of Construction:$ 2450 Utilities:0 Sewer ElSeptic Building Height: 1 story
QINNER/LESSEE CONTRACTOR•.
Name ROBERT CERVINO Name: RAY VILLANOVA
Address: 5264 MARGARET ANN LANE Company: VILLANOVA CONSTRUCTION INC.
City: FT. PIERCE State: FL Address: 2908 OLEANDER BLVD.
Zip Code: 34951 Fax: City: FT. PIERCE State:FL
Phone No. 772-%9%-5ss9 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.COM
from the Owner listed above) State or County License: CCC1327240
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPP.LEMENTAL: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:
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 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.
l/ s
_Signat a of Owner/Lessee/Agent Signatu of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF FLORIDA COUNTY OF FLORIDA
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this "V day of 20 16 by this-1 day of—SO to R, 20 16 by
rk U'� \ C� % „c.^s vend V\
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu c-State of Florida) (Signature of Notary P lic-State of Florida)
Personally Known OR Prod ceO _""'l
irg ldw Personally Known OR Produc d ntfffi, ion
Type of Identification Produced N Sate of O1F Type of Identifica W_,,,�dd_ �1 d
P Q,,, N— of Q es Dec 1 "pu"" Notary Public- pec 16.2016
Commission No h _ My C°ya�i #EE 8 oA
ta�y ssn' Commission No. y Comm• C � EE 858761
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Revised 07/15/20141 ' � P
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