HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: March 18, 2020 Permit Number: O SO6
RECEIVED
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
MAR-K*9.7016
Building Permit Applicatiwiitnng Department
St. Lucie County
Commercial Residential x
PERMIT TYPE: Single family residence
PROPOSED IMPROV�fVIENTLOCATION:
Address: 4920 Conley PI. Ft. Pierce FI. 34951
Property Tax ID N: 1313-131-0009-000-0
Site Plan Name: Moore
Project Name: Moore
Construct CBS 2br, 2bath, 4 car garage, single family home
Additional work to be performed under this permit —check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters
IElectric Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: 3594 Sq. Ft. of First Floor: 3594
Cost of Construction: $ 302,000 Utilities: _ Sewer Septic
Lot No.
Block No.
Windows/Doors
_ Roof Pitch
Building Height: 21'
OWIEfSE
CONTtCs/E ,'ll ,.. -;„
Name Joseph Moore
Name: Dave Golden
Address.63 Flores del Norte
Company: Dave Golden Homes
City:-Ft.Pierce State:_
Zip Code: 34951 Fax:
Phone No.732-939-6076
Address: 49001ndrioRd.
City: Ft.Pierce State: FI
Zip Code: 34951 Fax:
Phone No 772-216-5475
E-Mail: bmh550@hoymail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail dave@davegoldenhomes.com
State or County License CBC1253198
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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RECEIVED
"Ift
SUPPLEMENTALCONSTRUCTIQN LIEN:CAW
INFORMATION
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DESIGNER/ENGINEER:
Name: Todd N. Smith
Not Applicable
MORTGAGE COMPANY:
Name:
" st_LuNit)f l licable
Address: 1717 Indian River Dr. Suite 302
Address:
City: Vero Beach
Zip: 32960 Phone 772-669-3699
State; Fi
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR 1 ROYEMENTS TO YOUR PROPERTY. A NOTICE OF CO MENCEMENT MUST BE RECORDED AND
POSTED O��E JOB SITE BEFORE THE FIRST INSPECTION. IF YO TEND TO OBTAIN FINANCING, CONSULT
WITH Yniiiiiii$G AAAAFNnFR nu eN ATTDRNEY BEFORE RECORDING YOUR ICE OF COMMENCEMENT."
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Signature f Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF, FLORIDA
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Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification X.
Personally Known OR Produced Identification X
Type of Identif ion
Type of Identification
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