HomeMy WebLinkAboutBuilding Permit Application I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date: 12/22/17 Permit N mber:�
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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 i Re kideniial x
PERMIT APPLICATION FOR: Demolition
PROPOSED,I'M'PROVEMENT LOCATI.O:N,:.
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Address: � � � 5 A� N�IP— C
Legal Description: 07 35 40 S 162.5 FT OF E 67 FT OF W 293 FT OF NE 1/4 OF NW 1/4 OF, NE 1/,4(0.25 AC)(OR 3966-1472)
Property Tax ID#: 2407-121-0030-000-6 Lot No.
Site Plan Name: Sec/Town/Range: 07/35S/40E Block No.
Project Name: Demo of structure 4405 GARNER CT j
Setbacks Front Back: Right Side: Left Side:
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DETAILED D.ESCRIPTIONI OF WORK:
Demo structure and remove debris
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CONSTRUCTION WFORMATIOM..:
AdditionaFwork to be ertormed un er t ispermit—check all appy:
HVAC Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers M Generator a Roof Roof pitch
Total Sq. Ft of Construction: 720 S . Ft.of First Floor: 720 :1
4.900.00
Cost of Construction: $ Utilities: _Sewer Septic ;, Building Height:
OWNER/LESSEE: CONTRACTGRI
Name Gallego's Trucking Inc Name: �.
Address: 1875 Copenhaver RD Company: Blue Goose Construction LLC
City: Fort Pierce, State:FL Address: 9901 Okeechobee Road
Zip Code: 34945 Fax: City: I State:FL
Phone No.(772)216-8023 Zip Code: 34945 Fax: (772)468-4669
E-Mail:sandyv04O5@hotmail.com Phone No. (772)461-3020
Fill in fee simple Title Holder on next page(if different E-Mail: sholmes@bluegooseconstruction.com
from the Owner listed above) State or County License:;ICGC1517686
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: l
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:Gallego'sTrucking Inc Name:
Address: Address: 1875 Cope6haver RD
City: Fort Pierce, State: City: State:
Zip: Phone Zip: (Phone`
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:9901 Okeechobee Road 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 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 fori any restriction's 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 withl lender or an attorney before
commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
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STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucie COUNTY OF StLude J
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this -day of 7 iSCr_Cecr`as�� ,20j J by thisac� day 21D6!Ce m`��z ' 204.M by
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Scott Holmes Scott Holmes
Name of person making statement Name of person making statement
Personally Known x OR Produced Identification Personally Known X 'OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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(Signature of orida) (Signature of Notary k-' State of Florida)
NOTARY PUBLIC O� Cei�na Rose Hein )
Commissio D,�Seal) Commission (Seal)
IfPUBLIC
C=m#FF24J4966 6T TE OF,FLORIDA
OO lExpires 6/29/2019 Coiim#FF244
Fpi es 6/29/2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17