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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U
Date: 10/12/2017 Permit Number:
Building Permit Application
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 Residential X
PERMIT APPLICATION FOR: Building
.P_ROFOSED I[VIPROVEMENT LOCATION
Address: 4884 Watersong Way, Fort Pierce FL 34049 U kolxq
Legal Description: Lot 52 Watersong
Property Tax ID #: 2532-500-0066-000-5
Site Plan Name: Watersong
Project Name: Watersong
Setbacks Front 10 Back: 40
Right Side: 6 Left Side: 6
I Construction of a single family residence with 4 bedrooms and 5 1/2 baths.
ZHVAC Imo" J Gas Tank
2Electric 0 Plumbing
Total Sq. Ft of Construction: -5,861
Cost of Construction: $ 1,020,000
Lot No. 52
Block No.
this permit — cnecK ail tnat apply:
ZGas Piping _ Shutters Windows/Doors
Sprinklers 0 Generator 0 Roof 7/12 Roof pitch
Sq. of First Floor: 1,561
Utilities: L� ISewer ElSeptic Building Height: 31'-8"MHR
OVVN.ER/LESSEE:.
C..ONTRACTOR
Name Isabella' Halbert
Name: Mario Arbucci
Address:42 Maxwell Drive
Company: Coastal Construction and Design, Inc
Address: 1812 NW Old Oak Terrace
City: Kitchener State: ON
Zip Code: N2R 1A4 Fax:
City: Jensen Beach State: FL
Phone No. (519) 241-2198
Zip Code: 34957 Fax:
E-Mail: dihalbert@aol.com
Phone No. (772) 260-7514
Fill in fee simple Title Holder on next page ( if different
E-Mail: marbucci@comcast.net
from the Owner listed above)
State or County License: CRC013539
If value of construction is 52509 or more, a RECORDED Notice of commencement is requirea.
r� +
SUPPLEMENTAL-CONSTRUCT{ON
lLEN LAIN INFORMATION
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name: James Bushouse, Inc
Name:
Address:
Address: 1550 N Andrews Avenue
City: Pompano Beach State: FL
City:
State'
Zip: 33059 Phone (954)s552203
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY:
If 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 ermit 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 buildingpermit 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 Commencementmust be recorded and posted on the jobsite
before the first inspection. If you'intend to obtain financing, consult with leryder or an attorney before
commencing work or recording vour Notice of Commencement. 1 /
Si nature of Owner/ Lessee/Contractor as Agent for Owner
The forgping instrument as cknowledged before me
this 1day of 204 by
' (:�.�C_ r
Name of person nuiring statement
Personally Known OR Produced Identification
Type of Identification
Produced
of N06ry PuWcc- State'of
Commis%&.dck.MahStedt (seal)
M066937S)
REVIEWS I FRONT ING
COU TER I ROEVI W I S REVIEWOR
COI MPLET
Rev. 8/2/17
Signature of Contractor/License HoW"-----
STATE OF FL DA OW, PATRICIALAS
O y; . 4 MY COMMISSION N
COUNTY OF M d 7 -r i 1 11-=3 45# EXPIRES: Januar
The for Ding instrument was ackno'T w gr7'e 'GETc
this iT day of OCTV I3 E R . 20-12 by
/1? /be 10 /20 IV C C I
Name of pers n making statement
Personally Known V OR Produced Identificat "
Type of Identificati n
(Signature of Notary -Public- State of
Commission
RERO
V EW I VEGETATIREVIEW ON I SEATREVIEW I MR VIEW