HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE Wirm i.ETED FOR APPLI ATION TO BE ACCEPTCU
Date: SCANNtU Permit Number:
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MAY r 8 ?0t
._ St Lulc+eCo l!In
Building Permit Application p@m„,tm
Planning and Development Services Lu Cpate
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 COm ercial Residential x
PERMIT APPLICATION FOR: Building
Address: 1312, 1,on e f / A�e U-
Legal Description: LONE PINE SUBDIVISION (pb 51-21) LOT 3
Property Tax ID #:
Site Plan Name:
Project Name: f�
Setbacks Front "moo' Back:1
4036-1386)
Right Side: �� �� Left Side:
CONSTRUCT SINGLE FAMILY RESIDENCE
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Additional worK to be nertormed under tnls permit = check a
L �HVAC _J Gas Tank Gas Piping
Electric 0 Plumbing RJ Sprinklers
Total Sq. Ft of Construction: 3062
Cost of Construction: $ 100,000.00
S
Utilities:
Lot No. 3
Block No.
Shutters a Windows/Doors
J Generator R1 Roof Roof.pitch
of First Floor: 3062
Sewer ZSeptic Building Height:
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v OWNER �LESSE•Et� .; �. �¢f ,�,;�� r��; �
'_'�•^t::�t!;�+ 8i..,s�l�.{e,.tvn#.w5.�+'..i�itd'�l%�;tCa+�i't.'uM¢%.k,h� me `25��
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,raA %� h{•kz"' �u ar s.^f,��, �q� I^,.+ tL +,�.
Name' �✓ -Ter, ;Fl/ %9;7-2A rz,tta
Namw Ill i442 dardKr 1
Address: &Q'J tfL Came, C;Y \
le:
Company: GHO HOMES CORP
ss: ,s90 NFU ril �rG4nY-i l� PL
Addr�Pjl-
PORT ST LUCIE FL
City: State: _
City: St- to C; -p— State: FL
Zip Code: 34983 Fax:
Phone No. '�!p
E-Mail:-�2J�C�S'� tiyr`P� I_%i�e��I
Zip Code: 34986 Fax: 561-688-0909
��o. 772-873-1711
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Maid REBECCAD@GHOHOMES.COM
State qr County License: CBC051145
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
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tSURPLEIVIENTAL CONSTRUCTIONLIEN LAW I t3F0RMATIO,Nt
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _
Not Applicable
Name: DONALD J NUELLE
Name:
Address: 11634 SW ROWENA ST
Address:
City: PORT ST LUCIE State: FL
City:
State:
Zip: 34937 Phone561-629-6975 _
Of
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 ade to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to th issuance of a permit.
St. Lucie County makes no representation that is granting a perrr it 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 he�eby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Cod s 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 anlother non-residential use
WARNING TO OWNER: Your failure to Record a Notice (
improvements to your property. A Notice of Commen
before the first inspection. If you intend to obtain fina
commencing work or recording your Notice of Comm(
er/_tessee/CQn1ractXas Agent fo
STATE OF FLORIDA
COUNTY OF Q-C�
The fogwg instrument was acknowledged before me
this day of 1 20_,LQ by
1:4 l
Name of person making statement
Personally Known OR Produced Identification V
Type of Identification ��2 (.�y'—&-70 —77— t 3 e — p
Produced 32 -77— (,37 _U
(Sig ur f Not ic- State of Florida) RebecM
ommission o. `2�e efa % CommiSslony ry
*= F�cpires: Jan Aar
REVIEWS I FRONT- I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
Commencement may result in your paying twice for
�ment must be re trded and posted on the jobsite
cing, consult with I nder or an attorney before
icement.
Signature of Contrac i�1A Holder
STATE OF FLORI
COUNTY OF
The forgo• g instrument was acknowledged before me
this /. ay of Ar 41A, 20,2by
Name of person making statement
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
i(Si na e o tar ublic- ate of Florid a4beeCaD+m°
3OB76 4��,, ion 000600
fission N ,� r, CQ�a�py 9,2N
�NotaN �..... Via; bon ed 0►N won
SUPERVISREVIEWOR RE EW PLANS I V REVIEW EWON S EV EWLE I M EVIEWVE