HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Da I : July 10, 2018 RECEIVED WPW I iRumber: M C 'VoOa
'BY
JUL 10 ti018 a Lucie County
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BuRunvermit ApplicationIsri�1
Pi nning and Development Services t
��VYIOC�e Q� `
B {!ding and Code Regulation Division
2 DO Virginia Avenue, Fort Pierce FL 34982
P ione: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
P�RMIT APPLICATION FOR: Renovation
P.OSED IIVIPROUEMENTLOCATIU1
�,s�_h _ _�
A 'I ress: 9628 Enclave Circle
Le Ial Description: ENCLAVE AT THE RESERVE LOT 8 (OR 3723-1219: 3895-824)
Pill I perty Tax ID #: 3322-800-0011-000-4 Lot No.
S to Plan Name: Block No.
P oject Name Goschke Renovate Master Bath
letbacks Front Back: Right Side: Left Side:
a{ETAILED DESCRIPTION10F WORK �� u�, k 3� ;�a`�
1 hange (1) Toilet, (1) Shower & (1) Vanity Plumbing Location, Update Flooring, Fixtures, Vanities,
pdate & Add Electrical GFIs, Lighting per New Layout (See Plan)
I
CONSTRUCT(®N2INFORMAT104N
Mona work to eperformed under t isperm it — c eck all apply:
Piping Shutters ❑ Windows/Doors
❑HVAC L_Jj Gas Tank ❑Gas Pi
_
R1Electric 0 Plumbing ❑Sprinklers ❑ Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: Renovate 456 sgft. S Ft. of First Floor:
❑Septic
Cost of Construction: $ 23,000 UtilitiesliSewer Building Height:
OWNER/LESS'EE' n
CONTRACTOR - a t�,�'
<,
Name Ann Goschke (TR) & Doug Goschke (TR)
Name: Aurelio F. Pereira
Address: 9628 Enclave Circle
Company: Villadelta Construction Corp LLC
City: Port Saint Lucie State: FIL
Address: 1425 SE Village Green Drive
Zip Code: 34986 Fax:
City: Port Saint Lucie State: FL,
Phone No.
Zip Code: 34952 Fax: 888-869-1058
E-Mail:
Phone No. I
Fill in fee simple Title Holder on next page ( if different
E-Mail: bob@villadelta.com, yvonne@villadelta.com
from the Owner listed above)
State or County License: CRC058035
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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D SIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
I��me:
Name:
Pdress:
jty: State:
Ip: Phone
Address:
City:
Zip: Phone:
State:
I E SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY:
_Not Applicable
Name: Ann Goschke (TR) & Doug Goschke (TR)
Name:
ddress: 9628 Enclave Circle
Address:
City:
ity: Port Saint Lucie
lip: 34986 Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I Iertify that no work or installation has commenced prior to the issuance of a permit.
S I Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
w(tich is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
s ucture. Please consult with your Home Owners.Association and review your deed for any restrictions which may apply.
I consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
i accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
T e following building permit applications are exempt from undergoing a full concurrency review: room additions,
tn
cessory structures, swimmi
ng pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
eARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
provements to your property. A Notice, of Commencement must be recorded and posted on the jobsite
fore the first inspection. If you intend to obtain financing, consult with lender or.an attorney before
mmencing work or recording vour Notice of Commencement.,
Signature of Owner/ tessee/Contractor as Agent for Owner
igndture of Contractor/License Holder
STATE OF FLCII A
STATE OF FLORIDA
COUNTY OF Lc,c,
COUNTY OF.,��
The forgoing instru Tent was acknowledged before me
The for oing instrument was acknowledge before me
this day of 20f by
this day of riVkV-L , 20 y
9 2 L,� a Tg_r u "4
Name of person making statement
Name of person making statement
Personally Known OR Prod}ed Identification
Personally Known OR Produced Identification
7�
Type of Identification pr;vers
Type of Identif *cation
Produced:ii(j5aa -1509-40
Produced.t—�y��
:f
(Signature of Notary Publicignature
of Notary Public- State Florida)
�P I i rqZrU=Stt'
aof Florida
No. C?
/oif
0 lQI�JCommission
mmission No. (Seal)
a
My Commission GG 118783
iz
=ori Expires 06/26/2021
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COMPLETED
Rev.8/2/17