HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE.AcgEPTED TIqb
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Date: C7' 1, i Permit Number: o"
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Ul ing Permit Application Permitting
Planning and Development Services , LpjljPaA!
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL.34982 i
Phone: (772) 462-1553 Fax: (772) 462-1578 ' Commercial Residential X
PERMIT APPLICATION FOR: Building
,.,_. .,.,. ;. .:., . r''es—____.._-b...._'_::--'-'A `1.`r,: ...A -a ':. 'l i.... ,....i ... r•r_Y _.tr:; 'L , F; . .42 .. ,. , a
Address:' 15.3W3 Waldo Pe-O' r pC: Par- S+ ( tJ, 39cf S�'
Legal Description: Treasure Coast Airpark lot 35 (2 65 AC)(OR 3970-104)
Property Tax ID #: 4224-501-0035-000-2 Lot No.35
Site Plan Name: r/ Block No.
Project Name: 1
Setbacks Front/ Back: )g3, b, Right Side: /32. S Left Side: /3Z •.S�
Construct Single Family Res
s.. 3 &d
36W4 02Ca-.0c rA,1_af-e_ l
ZHVAC L —1 Gas Tank' Gas Pi
Electric RI Plumbing OSprinl
Total Sq. Ft of Construction: 3751/
Cost of Construction: $ 100,000.00
i
Generator
aWindows/Doors
Roof Roof pitch
S Ft. of First Floor: 3751
Utilities:0Sewer R1 Septic Building Height:
,�000NER/,L`ESSEE
.t..ns;'. 149k h,Z :5',Y'3 ,:M ;•S. ra",+r�-. ,.7 ;i �. (.e: , i, :.'t{ nG �
yK _ 7. '• {a<) , ,i.
Nam, - G i?-0 g. fit.
Address:D �% =S"! /' /bm_ �(�j a T.-ir-
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Name: will) am F4-4y)d/e/ r r
Company: GHO Homes Corp
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City: J �i" a•r- -r State: FL
Zip Code: 'Fax:
Phone No.
E-Mail:
Address:_5370 AIW
City: ,ek J71(,lit C4* -Z State: FL
Zip Code: 34986 Fax: 561-688-0909
Phone No. 772-873-1711
E-Mail: rebeccad@ghohomes.com
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
State or County License: CBC051145
If value of construction is/52500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTLON LLEN LAW INFORMATION
DESIGNER/ENGINEER: _ Not Applicable I
MORTGAGE COMPANY: _ Not Applicable
Name: Nuelle Engineering I
Name:
Ad d ress: 11634 SW Rowena St j
Address:
City: Port St Lucie State: FL
City: State:
Zip: 34967 Phone 561-629-6975 I
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Zip: Phone: L
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: Not Applicable
Name: Name:
Address: I Address:
City: I City:
Zip: Phone: I Zip: Phone:
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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 tolthe issuance of 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 Associatioj` 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 ilundergoing 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 I rider or an attorney before
commencing work orirecording your Notice of Commencement.
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4-0. 'i'+ta,
S gna ure o w er/ ess /Contractor as Agent for 0 t i r I
Signature of Contra icen 1 e
STATE OF FLORIDA " ' I
L(.lC�
STATE OF FLORI A
(A.1
+ COUNTY OF S• `-
COUNTY OF C:
The forgoing instrump= w s acknowledged before me
—:
The forgoing instrument was acknowledged before me
this L`day of ii Lo , 20 by
this _�rclay of MarCr— 201B by
Name of person making statement
Name of personlnaking statement
✓✓
Personally Known OR Produced Identification ��
Personally Known OR Produced Identification
Type of Identification tbL.
Type of Identification
Produced 11/1(Q/ U14 7 C q 377 0
Produ d
0 7 3 3 3 y al
i
ima
S' ur f ar ublic- Sta�te6; of Flo i
(Sign a Notar -State of Florida) �e'p0� 6
DBCGit
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Commissio? �� mission #@�4�76 I
9 621 I
Co fission o. "' ���SS�C �aH
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*= January
Expires: Iagd
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--,'� Bonded thru Aaron Notary i
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REVIEWS
FRONT
ZONING
SUPIERVISOR
PLANS
VEGETATION
aye\
SEA TUffl MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW REVIEW
DATE
I
RECEIVED
DATE
COMPLETED
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Rev. 8/2/17
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