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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/10/18 Permit Number: 1901
RECEIVED
Building Permit Application
Planning and Development Services JAN 3.'0 niq
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Countv
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION:
Address: 3702 North Highway A1A
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name: Grand Isle Condominium
Setbacks Front Back:
DETAILED DESCRIPTION -OF WORK:
Right Side: Left Sider
Lot No.
Block No.
Repair one broken slab. post -tensioned cable.
CONSTRUCTION INFORMATION:
Additional work to e nertormed under this permit— check a apply:
EHVAC0 Gas Tank ❑Gas Piping _ Shutters Windows/Doors
11 Electric El Plumbing []Sprinklers F]Generator E]Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ $7,500.00
S Ft. of First Floor:
Utilities: Sewer DSeptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Grand Isle Condominium Assoc.
Name: James Wilson
Address: 3702 N. Highway A1A
Company: General Building Services, Inc.
City: Fort Pierce State: FL
Address:
Zip Code. 34949 Fax:
City: Tequesta State: FL
Phone No. 615-953-9099
Zip Code: 33469 Fax:
E-Mail: lsalamone@olitiook.com ':
Phone No. 561-262-6853
' E-Mail: jawjr59.@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License: CGCO58645
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN 11AW INFORMATI4N
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: CSM Engineering LLC
Name: N/A
Address: 206 Swocean Blvd.
Address:
City: Start State: FL
City: State:
Zip: 34994 Phone 772-220-4601
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name: wA
Name: N/A
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
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencling,work or recording our Notice of Commencement.
ignature of Owner/ Lessee/Contractor as Agent for Owner
o actor/License Holder
STATE OF FLORIDA
(JTATEF FLORIDA
COUNTYOF -rQDl/4-,D �iv'2rc
COF P- h6t--Gu GIC_
The forgoing instry�nent was acknowledged before me
The fqr oing instrument was acknowledge before me
this 1� day J(':l V
this day-- 1� ce.m13 c2 20dF by
of , 20�by
40013 519L_'0MC"U -,-
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Name of person making statement
Name of person making statement
Personally Known ti/ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
FL
Produced
Produced
lic- Florida)
(Signs Notary Public- State Florida
(Signature of Notary P State of
re of of )
Commission No. os�`. k_ (S '�PE���
Commission No. ��"' "'� LLEN HN
* *MYCOMMISSION #GGO&SM
*,State of Florida -Notary PublicEXPIRES:
iwiv
May23,2021
,�` C�Ommission # GG 270079`
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tev. 8/2/17