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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: /C,?' �� Permit Nurtibalilk Building Permit Appi Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial mc"LUVED n DEC 2 S 2018 Permitting Department Pt. Lucie ounty, FL PERMIT APPLICATION FOR: Building - - COROPOSEDaIfV1FyRO�UEMEN6f;l©CAiTI®IV,-''?L';xu�*'n�'� r{ ;. r ' z� Address: Legal Description:F1YS't r2.plQA 1Yl MkQLClDW(DQd 10111 1-Y11rU- lotISO (or 401 -Ic1U: L4 lab-14ba i) Property Tax IDN: M-514'5DW-L7OM'tJM— Lot No. Site Plan Name: BlocKp6ANNED Project Name: cr I •� . Setbacks Front %S r S Back: 4S r Right ht Side: / 2 • <-i Left Side: /Z . S" Construct Single Family Residence D L ZHVAC ❑ Gas Tank ❑Gas Piping 0 Shutters �✓ Windows/Doors EElectric Plumbing Sprinkler) Generator Roof r= Roof pitch Total Sq. Ft of Construction: ?%% S 5 Ft, of First Floor: Cost of Construction: $ �5 Utlllties:12Sewer Septic Building Height: C ®a orryN,ER�LE55EE�,y�g, Name 4201- C," MXAA,, food LI.L Name: W,IHAlao 4,ikic) IrY Address:5-10 /VW M$YGcIrAilP lab- Company: GHO Homes Corp City: Port St Lucie State:FL Zip Code: 34986 Fax:561-688-0909 Phone No.772-673-1711 Address:5476 NW YAfYrcY)4iI-Q. PL. City: Q} S4- tmec L Zip Code: 34986 Fax: 561-688-0909 Phone No. 772-873-1711 State:FL E-Mail: rebeccad@ghohomes.com Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail: rebeccad@ghohomes.com State or County License: CBC051145 IT value or construction Is , Zsoo or more, a RECORDED Notice of commencement Is required. OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as Indicated. I certify that no work or Installation has commenced prior to the Issuance of a permit. St. Lucie County make no representation that is granting a Permit will out horize the permit holder to build the subject structure which is in conflict with an applicable Home Owners Association rules, bylaws qr antl covenants that may restrict or prohibit such structure. Please consult wylth 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, 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 f spection. If you intend to obtain financing, consult with I der or an attorney before commencingwok or recordingour Notice of Commencement. s 1 Rev. B/2/17 yy',l�'-.. 'r".: r '4 t �nn., g ..4' N DESIGNER ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: A/utLlt �tna�rlerrrna Name: Address: ++���ros+ Address: City: State: _ City: vcns+wm State: � Zip: ,our Phone se+sxsasrs Zip: Phone: FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: Signature of / L ee ntractor as Agent for Owner Signature of o /License Holder STATE OF FLO D • C- STATE OF FLORIDA , 4-� UG COUNTY OF COUNTY OF . • The forgoing Instrument was acknowledged before me The forgoing Instrument was acknowledged before me this j�tfay of 'T7.e L . 20A by this *day of n P,Ci . 20f 8 by /.(i I�I1 �t WI Ji'kyla J.ef I.V �))iAwl 4-E RY4�lt✓ Name of person eking statement Personally Known � OR Produced Identification _ Name of person making statement Personally Known J� OR Produced Identification Type of Identiflc Type of Identification rodu 7roduce (Slgnatur of Nota lc- S g f Florida IABbBCCa ����� 4 GG46087 (Sig a of ry Pu a of Florida I Rebecca Dima Ca ssion N tg@@(�isstonu� 9, 202 C mmissian No ����G's% (gammission � GGO608 0 _� *= pgttln Kota ='.E:cpifes:�No�� N g�onided ihru nded REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED