HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICIABLE'INFO MUST BE COMPLETED FOR
Date: �1`1 I \�
Building
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 .Fax: (772) 462-1578
CATION TO BE ACCEPTED
Permit Number: N N 1 d 111
RECEIVE®
rmit Applicatio JUN 07 `018
ST. Lucie County, Permitting
Commercial
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Residential X
PERMIT APPLICATION FOR:
Building
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!?ROPOSEaDIMPROV,�EMENTLOCA�TION.
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Address: 70 .en-i &a -P, IJ r•
Legal Description: Monte Carlo Country Club - Unit Two - lot
Property Tax ID #: 1334-502-0015-000-8
Site Plan Name: cam.
Project Name: �1 5
Setbacks Front 25-Ir Back: 74.7' Right
Construct Single Family Residence
(OR 4071-890, 4102-1769)
Left Side��`�'
Lot No. 98
Block No.
Aaaitionai worK to ajpnjerrormea unaer tnis permit — cn cK all inat appry:
RIHVAC LJ Gas Tank Gas Piping 11 _ Shutters F✓ Windows/Doors
RjElectric 0 Plumbing prinklers L] Generator rV_1 Roof Roof pitch
Total Sq. Ft of Construction: 3�_31" S�Ft. of First Floor: 3221
Cost of Construction: $ 100,000.00 Utilities: I_J Sewer Septic Building Height:
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OWN,ERf LESSEE a z i,�n F+ }, ,.COI�'TRALTOR
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Name'RG.rioGri..►- Skawn Zi,VYA!4
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Name: 1A)) �i C�y�-UG,n j.
Address: fW ML6,qmW.FW C
Company: GHO Homes Corp
City: A ra 12, ea rh State: �'
Address: S90 NW M er G ay+; I -e- �.
Zip Code:.3LG%6, 0 Fax: I
City: ell- - G/-2� State:FL
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Phone No. l q — Y-51 — Z 3 zZ I
Zip Code: 34986 -- Fax: 561-688-0909
E-Mail: 'f01 )-0 0, a inv I
Phone No. 772-873-1711
Fill in fee simple Title Hol r on next page ( if different
E-Mail: rebeccad@ghohomes.com
State or County License: CBC051145
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: _ Not Applicable
Name: c ' n
Address: /
City: A- ) e- State:
Zip: 6-:� Phone
MORTGAGE COMPANY: _ Not Applicable
Name: e
Address:
City: State:
Zip: Phone:
1
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FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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.
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, sc�een 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 re orded and posted on the jobsite
before a first inspection. If you intend to obtain financing, consult wit lender or an attorney before
comrp pjpg work or recording your Notice of Commencement.
re of Owner
STATE OF FLORIDA
COUNTY OF
The forgoing ins
thi v of
14,
:ontractor s Agent for &ner
acknowled$$ kiefo me
20U,� by p
�.I1 1zJ 9 n111n�1
V Name of person making statement L____111
Personally Known OR Produced Identification
Type of Identificat� 1i1�
Produced l�
REVIEWS
My Comm. F
FRONT I ZONING
COUNTER I REVIEW
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
Notary Public — Stateiof F
Commission A GG 138!
My Comm. Expires Sep 11
Signature of Copog6//0cense Holder
STATE OF FLORI 11 / ,
COUNTY OF �J iy C4 e
The forgoing instrurr=tt was acknowledge before me
this,.!;'�lay of u n -r-, 20/by
Name of person making statement
Personally Known / OR Produced Identification.
Type of Identification
Produced �--�
';Zol �16
re oj,46-ta Public-S �1
on No. Q' �o -I
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