HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONs
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/5/18 Permit Number:
S- CANNEO .
St Lucie COAV RECEIVED
Building Permit Application MA4 oisiyw
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 i St. Lucie County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Renovation
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Address: 3313 Bent Pine Dr.
Legal Description: MONTE CARLO COUNTRY CLUB -UNIT ONE- LOT 29 (OR 3667-1768: 4076-1760)
Propertv Tax ID #: 1327-801-0033-000-6
Site Plan Name:
Proiect Name: Kochanowski Windows/Door Alterations and Kitchen Renovation
Lot No. 29
Block No.
Setbacks Front Back: Right Side:
Left Side:
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E1HVAC
ZElectric
21 Plumbing
Generator
QWindows/Doors
Roof Roof pitch
Total Sq. Ft of Construction: I S . Ft. of First Floor:
Cost of Construction: $ ,' Utilities:cnSewer Septic Building Height:
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Name Andrea Kochanowski
Name: David "Harley" Van Ginhoven
Address: 3313 Bent Pine Dr.
Company: DC Construction & Company, Inc.
City: Fort Pierce State: FL
Address: 1916 21st Ave.
Zip Code: 34951 Fax:
City: Vero Beach State: FL
Phone No. (772) 834-4692
Zip Code: 32960 Fax: (772) 567-4237
E-Mail: kochanowskikids@gmail.com
Phone No. (772) 360-8571
Fill in fee simple Title Holder on next page ( if different
E-Mail: harley@ibuildwithcare.net
State or County License: CGC1507644
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER:
Name: Andrea Kochanowski
Add ress: 3313 Bent Pine Dr.
City: Fort Pierce
Zip: Phone
_ Not Applicable
State:
MORTGAGE COMPANY: _ Not Applicable
Name: David "Harley'' Van Ginhoven
Address: 3313 Bent Pine Dr.
City: Vero Beach State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Ad d ress: 1916 21 st Ave.
_ Not Applicable
BONDING COMPANY: Not Applicable
Name:
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 ofCommencement 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
commencing work or recording vour Notice of Commencement. �.11
of Owner/ Lessee/Contractor as Agent for Owner I Signattre of Contractor/License Holder
STATE OF I STATE OF FLORIDA
COUNTY OF FLORIDA!1- - L COUNTY OF S j=e L k4E t
The for oing instrument was ack(�n'owledged before me
this day of T r tFiZ C:_ \ 20_q-by
Andrea Kochanowski
Name of person king statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary P bll - StT.11.11
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HlYJt?IiNSO!V
lqp� Notary Public - Statoof f
Commission No. Commission#GG110
My Comm,Expires Sep 2
Nrnard!L,ntn;t• 4: hrnal N11
REVIEWS I FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
The for oing instrument was acknowledged before me
this day of
David Van Ginhoven
Name of person making statement'' '
Personally Known OR Produced Identification I
Type of Idectification
Produced ;D L V EA 5/ (, �3 5 7
ig ture of Notary
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NANCYJOHN50N
t om ission No.
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Notary PL WteofFlorida
2021
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Comml Sion # G 110108
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My Comm. Expires Sep 23, 2021
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