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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �- ' a �\ } Permit Number:
ERECBuilding Permit Applicatio20
Planning and Development Services rmitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 46I2-1578 Commercial Residential X
PERMITTYPE: Building
:PROPOSED IMPROVEMEN_T.LD_CATION:-
Address: cl u 2S L/-n(bl k WOO d Ln
Property Tax ID #:0009 ' M7 —I Lot No.q_
Site Plan Name: Block No.
Project Name: MVJ - tr�
--
DETAILED PESCRIPTIOU'OF WORK: - -
Construct Single Family Residence
Bedrooms: 3 Bathrooms: 3 Garage: 2—
CO NSTRU.f+TIO'-N INFORMATI0-M
Additional work to be performed under this permit —check all that apply:
/LMechanical _ Gas Tank _ Gas Piping _ Shutters '� Windows/Doors
[Electric -Olumbing ✓Sprinklers _ Generator Roof Pitch
Total-Sq Ftiof�Corrstruetion. Sq. Ft. of First Floor.
Cost of Construction: $ 100-000 Utilities: i/ Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
NameGRBK GHO Meadowood LLC
Name:William Handler
Address:590 NW Mercantile Place
Company:GRBK GHO Homes LLC
City: Port St. Lucie State: I
Address:590 NW Mercantile Place
Zip Code: 34986 Fax.-561-688-0909
City: Port St. Lucie State: FI
Phone No.772-873-1711
Zip Code: 34986 Fax: 561-688-0909
E-Mail: Permitting@ghohomes.com
Phone N0772-873-1711
Fill in fee simple Title Holder on next page ( if different
E-Mail Permitting@ghohomes.com
from the Owner listed above)
State or County LicenseCBC051145
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.
l0-10
SUPPLEMENTAL CONSTRUCTION
LIEN'LAW INFORMATION:
DESIGNER/ENGINEER: _'Not
Applicable
MORTGAGE COMPANY:
,Not Applicable
N am e: Nuella Engineering
Name:
Add Tess: 11634 SW Ravena St
Address:
City: Pon St. Lucie
Zip:34987 Phone661.429.8gr6
State: FI
j
City:
Zip: Phone:
State:
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 co menced 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 consultwith 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 OWJNR' YOUR FAILURE TO RECORD A NOTICE OF COMMENC MENTMAY RESULT IN YOUR PAYING
TWICE FOR IMOVEMENTS TO YOUR PROPERTY. A NOTICE OF COM CEMENT MUST BE RECORDED AND
POSTED ON TJOB SITE BEFORE THE FIRST INSPECTION. IF YOU INT ND TO OBTAIN FINANCING, CONSULT
WITH YOUR LEER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICIE OF COMMENCEMENT."
Signature of Ow . / ntractor as Agent for Owner
Sign ontrac License Holder
STATE OF FLORID7
STATE OFF RI
COUNTY OFSt. Lwe
COUNTY .Lurie
The f2fpoing instrurgAnt Was acknowledged before me
The forgoing instrum t was acknowledged before me
this ay of 1-66 202L by
this jt5lkday of 20 - by
<<iiCtrn H�ihdler
�� I I iGh�1 t-ICtnd i I�
Name of person making statement.
Name of person making statement.
Personally Known _ OR Produced Id itCatj&
Personally Known OR Produced Identificatio a o^y
Type of Identification y • sN
ed
Type of Identification tiry
Produced Q�
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ommission No. {��},
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VEGETATION
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REVIEW
DATE
RECEIVED
DATE
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