HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONM 1 M
LLL P ,LICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
D e: �g G Permit Number:
"139
,�j� SCAN`.
4.ipi�09RECEIVED
Buildingit Application
Pf' Wing and Development Services AU0 V G 21.118
Bu ding and Code Regulation Division I ST. Lucie County, Permitting
23 0 Virginia Avenue, Fort Pierce FL 34982
Phi ne: (772) 462-1553 Fax; (772) 462-1518 Commercial Residential x
PE
MIT APPLICATION FOR: Building -,
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'i i Y
APR
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Add ess: z3a a-ca - e n -r og . /6 Lt I f
Leg' Description:y/14e 06 k jo O h •e
a2 v o - 2
Pro l rty Tax ID #: �,3Z7- c'o - Oyd'y - DDO - b? Lot No. 2 _7
Site' Ian Name: Block No.
Proj ct Name:
Set l acks Front 7 s •s Back: _ Right Side: 26 •y , Left Side: Z •U
�.wt �"� a ;57s","zaai. '�.. . tr "�„r.�,, '> r ¢ r`r - t^ � , W a x x 7•s � ,:t
a:*..#.�Sdiafir,;a
Con truct Single Family Residence
Ad
ILional worK to be ertormed
HVAC Gas Tank
under this permit— checK all that
Gas Piping
apply:
Shutters
Q Windows/Doors
tl
Electric
Plumbing
ZSprinklers
Generator
FV] Roof Roof pitch
TotFt
of Construction: —Z& B
S . Ft. of First Floor: 3Z
(0 p
Coonstruction:
$ 100,000.00
Utilities:
W 1
Sewer
Lj
Septic
Building Height:
T
'ER�LESS;E�,
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FW',IIiitlo
NarnIl
Add
CWo M-ekdowooa L.LC—,
Name: }--i-cl1e
Company: GHO Homes Corp
less: 590 /VW M-eY-G ctY-rH I * IAL•
City,
Port St Lucie State:FL
Address: 9)6 1VW YAeI'cGrl-W I.-Q pL .
Zip
Phol
ode:34986. Fax:561-688-0909
a No.772-873-1711
City: 194- S� b-ttie� State: FL
Zip' Code: 34986 Fax: 561-688-0909
E-
il:rebeccad@ghohomes.com
Phone No. 772-873-1711
Fill i,i
E-Mail: rebeccad@ghohomes.com
fee simple Title Holder on next page ( if different
State or County License: CBC051145
fron
the Owner listed above)
n Wipe or construction is >LSuu or more, a Kttcutcuto Notice of commencement is required.
*(9050
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D
IGNER/ENGINEER: _ Applicable
MORTGAGE COMPANY: _ Not Applicable
N�Not
ne• £ 'her '
Name:
Add•ress: +1esaswaowa�s,
Address:
Ci
Pottstil State: n_
City:
State:
Zi ''
34987 Phone 561-629.6975
Zip:
Phone:
FE
SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Nay
_
e•
Name:
Ad
Tess:
Address:
Cis •
City:
Zip:
Phone:
Zip Phone:
OW ER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I ce fy that no work or installation has commenced prior to the Issuance of a permit.
St. L ie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
whit is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
strut ire. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In co sideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
ill rdance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The f illowing building permit applications are exempt from undergoing a full concurrency review: room additions,
acce ory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
Ill
WAI NING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impi 3vements to your qroperty. A Notice of Commencement must be recorded and posted on the jobsite
befo,�e the first inspeetiibn. If you intend to obtain financing, consult with lender or an attorney before
comlh nencine work or r ordine vour Notice of Commencement. 1
i
Sig
ture of Owner/ actor as Agent for Owner
Signature of Contra se Holder
ST
COS
E OF FLO&DA
�, � G1 e—
STATE OF FLO
COUNTY CiC
NTY OF -S •
OF
The
this
or Ing Instrume t was acknowledged before me
day of i 20& by
The forgoing instrument was acknowledged before me
this day of 20L by
W II ;ciw, a Jey-
Pell
Name of person aking statement
nally Known OR Produced Identification
Name of person making statement
Personally Known _� OR Produced Identification
T
f Identification
Type Qf1dertification
roi
luc
nini
oduced
(
ature ary P lit- State �$i��4i,� i
mission # GGO
�Ndll State o,
0,...+,G
`
Co
issi (al)j(®iNUn'2
commission
fission
ires:
...• Bond
oz; Bonded N
RE
I IEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
D
R ER
DAT
I
CO
PLETED
Rev. 8/,2/17
2021