HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 ' m Permit Number: Cay/� 6 V
44—
LUC E � RECE1v�D
p ...=.. s NOV 112020
Building Permit Application
Permitting
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION:
Address: 9614 Knollwood Lane
Property Tax ID #: 1327-701-0019-000-5
Site Plan Name:
Project Name: Monte Carlo Country Club
DETAILED DESCRIPTION OF°WORK:
Construct Single Family Residence
2 car garage
New Electrical Meter X Second Electrical Meter
CONSTRUCTION INFORMATION:,
ST. Lucie County,
Residential X
Lot No.49
Block No. unit 3
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"153,s
Generator _ Roof
Sq. Ft. of First Floor: 3453
Cost of Construction: $ 100,000.00 Utilities: —Sewer —Septic Building Height:
Pitch
OWN ER/LESSEE:
CONTRACTOR:
Name Carla S Cunningham
Name: William Handler
Address:9610 Knollwood Ln
Company: GRBK GHO Homes LLC
Address:590 NW Mercantile PI
City: Fort Pierce State: _
Zip Code: 34951 Fax:
City: Port St Lucie State: FL
Phone No.772-464-9952
Zip Code: 34986 Fax: 561-688-0909
Phone No772-773-0075
E-Mail:rent1123@bellsouth.net
Fill in fee simple Title Holder on next page (if different
E-Mailpermitting@ghohomes.com
from the Owner listed above)
State or County License CBC051145
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
5'7_'j2-6o7-z3 zl• Rdoecc.a
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name: Nuelle Engineering
Name:
Address:
Address:11634 SW Rowena St
City: State:
City: Port St Lucie State: FL
Zip: 34987 Phone661-62M975
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: x Not Applicable
_
Name: same as owner
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. LucieCounty 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.
Lucie County 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.
E;,Signature=of;ContractorAic6nse Holder
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
Sgtr4 Live
STATE'OF`FLORIDA
COUNTY OF e,
COU,NTY�OF '.
<„
Sworn to (or affirmed) and subscribed before me of
4S-worha6o or Wirmed)1and_subscribed before me of
�hysical Pres nce or Online Notarization
ov
Physical Presen&-or Online Notarization
this day of �ZU2020 by
this day -of= w'� 2020 by
Name of person making statement.
Name of person making statemen
Personally Known OR Produced Identification
Per-sonally'Known OR Produced Identification
Type of Identification
Type-ofldentificati'on ��.•,..,`�.-.�z �„`
Produced
Produced
ef
of"Not y Public State'of Florida )'U` _ r
(Signature of N t Public- State of lord "WAY R,wswe«irptu
Rorie C Long
Commission No.23 91Lf3� alY 11w
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issi No. (Seal)
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