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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED g
Date: Permit Number:
19 Llo ILUCHIE
O
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: New Construction- Single Family Residence
PROPOSED ,IMPROVEMENT LOCATION. .
Address: k,565- 1*O_T &49A__1PY" A,,;F
Property Tax ID #: /33"il - iofl - Vd3I - no Lot No.
Site Plan Name: WJH FL LLC - Wade Jurney Homes Block No.
Project Name: Lakewood Park
DETAILED DESCRIPTION
New Construction- Single Famuly Residence
i- -
/.
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical —Gas Tank —Gas Piping _ Shutters windows/Doors _ Pond
Viectric YAlumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: / o Sq. Ft. of First Floor �aV
Cost of Construction: $ oS ad in Utilities: _ Sewer Septic Building Height.
OWNER/LESSEE:
CONTRACTOR:
Name WJH FL LLC- Morey Doyle
Name: Morey Dayle
Company: WJH FL LLC - Wade Jumey Homes
Address: 3091 Governors Lake Dr Suite 300
City: Norcross State: GA
Address: 3091 Governors Lake Dr Suite 306
Zip Code: 30071 Fax:
City: Norcross State: GA
Phone No. - (321) 270-6629
Zip Code: 30071 Fax:
E-Mail: Heather.Dahlin@CenturyCommunities.com
Phone No (321) 270-6629
Fill in fee simple Title Holder on next page (if different
E-Mail Heather.Dahlin@CenturyCommunities.com
from the'Owner listed above)
State or County License rc,,r151745A
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
Name: FDS Eng inq eering Associates
Address: 258 Southhall Lane, Suite 200
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: Maitland State: FL
Zip: 32751 Phone (321) 972-0491
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
City:
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 our Notice of Commencement.
Alon�
Signature of Owner/ L se ontractor as Agent for Owner
STATE OF FLORIDAn
COUNTY OF 4m�
Sworn to (or affirm ) and subscrib d before me of
Physical Presence or Online Notarization
this � day of 20 by
ff�QXA A knnI .Z)
Name of person magi statement.
Personally Known V OR Produced Identification
Type of Identification Produced
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Notary Public State of Florida
�P Heather Dahlin
My Commission HH 029010
jOr/► Expires 08/05/2024
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