HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED —
Date: $ a,Permit Number:? 0 0 9— a3 1
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Planning and Development Services
Building Permit Application Aus 9 4020 I 110
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
ST• Lucie County, Permitting
Residentia
PERMIT APPLICATION FOR: S
PR
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Address: 11690 Palomino Drive Saint Lucie County, FI.34987
Property Tax ID #: 3309-605-0037-000/2
Site Plan Name: Pony Pines
Project Name: Cherrie Lafond .
New home construction
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New Electrical Meter Yes Second Electrical -Meter
Lot No.34
Block No. A
Additional work to be performed under this permit --check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: 4,665
Cost of Construction: $ 200,000.00
Generator Roof Pitch
Sq. Ft. of First Floor: 4,665
Utilities: _ Sewer _ Septic Building Height: loft
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O,WzNER/LESS'EE�s F P`.°�iCONTRA.tq
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NameJohn Murtagh & Cherrie Lafond
e:
Address:5268 Nw West Lovett Circle
Compan .
City: Port Saint Lucie State: _
Address:5268 West Lovett C' e
Zip Code: 34986 Fax:
City: Port Saint Luci State: FI
Phone No.772-333-6907
Zip Code: 34986 Fax:
E-Mail:blessedmomm2l@gmaii.com
Phone N0772-3 6907 954- -8566
Fill in fee simple Title Holder on next page ( if different
E-Mailfree.jpKnny6@gmaii.com
from the Owner listed above)
Sta County Licenseowner contractor
If value of construction is 2500 or more, a RECORDED Notice of commencemem is requirea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEIV ENTAL�CONSTRIJCTIONS LIEN
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:
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Luci ounty and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
%mifh I ndar nr ao nttnrnpv hafnra rnmmpnrino wnrk nr recnrdina vnur Nntice of Commencement.
Signatu of Owner/ L ssee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 5 k .
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this *N!! day of a. J� 2020 by
this day of . 2020 by
A/ i'.
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced_X71
Produced
�EANNA MM E GNENS
(Signature of No ; St
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(Signature of Notary Public- State of Florida )
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Q5 EXPIRES: DO r
P n TW NOta Public Underwriters
Commission No. d°
Commission No. (Seal)
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