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4LLAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I r�
Date: 10-15-2018 Permit'Number:
Building Permit Application RECEIVE
Planing and Development Services OCT 16 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial R sQc$trpti ttitig Departmeni
PER, APPLICATION FOR: Renovation
PROPOSED IMPROVEMENT LOCATION:
, 34990
13054 NW Gilson Road, Palm City, Y
Legal Description: SEE ATTACHED LEGAL DESCRIPTION SCANNED
BY
V
Lucie luounly
Property Tax ID #: 4425-312-0020-000-1 Lot No.
Site Plan Name: Block No.
Project Name: Pam Alexander Residence
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
(Kitchen remodel)
Close in one (1) picture window in kitchen, add plumbing for one slop sink in adjoining room.
CONSTRUCTION INFORMATION:
a
I!IHVAC L J Gas Tank UGas Piping
❑I Electric Z Plumbing Sprinklers
Total Sq. Ft of Construction: 550
OU
Cost of Construction: $ o 0
apply:
Shutters ❑ Windows/Doors
Generator Roof Roof pitch
Scn of First Floor: 9941
Utilities: _Sewer 0Septic
Building Height: 2
OWNER/LESSEE:
CONTRACTOR:
Name Pam 2015 Residence LLC
Name: Richard P Duffield
Address:7900 Glades Road, Suite 402
Company: Sunstate Contractors LLC
City: ;Boca Raton State: FL
Zip Code: 33434 Fax: NA
Phone No.954-328-3833
E-Mail: Pheinc@mac.com
Address. 2697 SW Domina Road
City: Port St Lucie State: FL
Zip Code: 34953 Fax: 407-241-8662
Phone No. 772-224-2793
Fill inllfee simple Title Holder on next page ( if different
from the Owner listed above)
i
E-Mail: ricky.duffield@gmail.com
State or County License: CBC 1231719
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
I
DESIGNER/ENGINEER: _ Not Applicable
Name: JAVIER CISNEROS (Benchmark Engineering)
Address: 806 Delaware Avenue
City: Port St Lucie State: FL
Zip: 34946 Phone 772-519-2679
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Address:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I ceriifV 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 cohsideration 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, 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 lender or an attorney before
commencing work or re_cordini; vour Notice of Commencement. IL
Less
for Owner I Signature of
TE OF FLORIDA STATE OF FLORIDA
JNTY OF LLs<,,ie COUNTY OFSAwTLUCiE
The forgoing instrument was acknowledged before me
this L�_ day of _()j�� 200by
Name of person making statement
Personally Known x OR Produced Identification
Typb. of Identification
Produced �(
ature of Notary Public- St6fe of
Commission No.
REVIEWS
I
DATE
RECEIVED
DATE
COMPLETED
Rev. 8%2/17
FRONT I ZONING
COUNTER REVIEW
9-4
older
The forgoing instrument was acknowledged before me
this f& day of OCTOBER , 20JI by
Richard P Duffield
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of otary Public- State of Florigidl FF;'-E
Commission No. (Seal)
Ie
VEGETATION SEATURTLE I MA.
REVIEW REVIEW RE 99 go?-E
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