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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
.401-
Permit Number: 1.�J - 72 !
RECEIVED
MA 2 5 1021
BuildingPit A IicatioffrMittin9DePartrngnt
ermpp St. wclo county
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
PERMIT APPLICATION FOR:
PROPOSEDIMPROVEMENT LOCATION:.,
Address: 5513 Spanish River Road, Ft Preice FL 34951
Residential
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name: House Renovation
DETAILED DESCRIPTION OF WORK;
Renovate Master bathroom, guest bathroom, and upstairs bathroom, replace Kitchen cabinets, 4 interior d000rs, drywall repairs.
Drywall the kitchen, kitchen nook, bathrooms and living area.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 73920.00
Generator
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
Roof Pitch -
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Peter Urquhart
Name: Chester Forbes
Address:610 Benton Rd
Company: Forbes Remodeling & Construction LLC
City: East Meadow FL State: _
Address:4017 Pines Industrial Ave #R
Zip Code: 11554 Fax:
City: Rockledge FL State:
Phone No.516-695-2494
Zip Code: 32955 Fax:
E-Mail:Peteru601@aol.com
Phone No321-591-5053
E-Mailfrcllc2019@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License CGC1 528947
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.
SUPPLEMENTAL CONSTRUCTION LIEN 'LAW INFORMATION:
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.
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 your Notice of Commencement.
t for Owner
Sig atu a of Owne0,A
essee/Contractor as7d-8
Signature of Contractor/License Holder
STATE OF Fl. �STATE
OF FLORIDA
COUNTY OF
COUNTY OF
to,
. w n to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
P Pr nce r Online Notarization
th� day of , 2fM by
Physical Presence or Online Notarization
this _ day of , 2020 by
Name of person maft'statlement.
Name of person making statement.
Personally Kn wn OR Produced Identification 1�
Personally Known OR Produced Identification
Type Ide ' rca ' n 2
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Type of Identification
Produ ed
Produced
nat a of NotarJPIl :ofFI rl NAPEL�DRIVE
(Signature of Notary Public- State of Floridallotary
Pubiic • SCommission
Comm NCommission
No.' i1oF���
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No, i (Seal)
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