HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL -APPLICABLE INFOO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPYED
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Date: � � �.� � ,p(i ---- ------ PermittJumber:
�J�S RECEIVED !� -1
Building Permit Application JAN 0 2 2019 Gc� n
Planning and Development 5ervices
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
ST. Lucie County, Permitting
Residential X
PERMIT APPLICATION FOR: Building n
Address: ` Ul ;kr) LnC % 1 W CX)a Ln "_ VlAr fL I- L 34ci5 1 (iU`�(It/
Legal Description: ihor&C Carlo Pouf 4rV C66 - Una-flnr1.e - LAMS o (or 1-10711 ^ INLo : gla5 -ISa-i)
Property Tax ID q: _l32'1^ ^10 1 - ggoal0- OQb--7 Lot No.5W
Site Plan Name: Block No.
Project Name:
Setbacks Front %S- �
Back:
Construct Single Family Residence
V
Z Right Side: - S Left Side: 2-7 S
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e rz, on._o 2 t -/
2,-4.-
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nVwulq 101 WU1N W uC
Z11
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CIIUIIOCU UIIUCI 1li FJCJ II n L—WIC6K GII nFJply:
Gas Tank Gas Piping Shutters
Z
Windows/Doors
_
RElectric 21
Plumbing
Sprinklers
Generator
9
Roof Roof pitch
Total Sq. Ft of Construction: �7—% 2-0 &,�_
5 Ft. of First Floor:
2 %Z U
Cost of Construction: 0 �.
Yf10 .60 Utilities:C2
Sewer
[]Septic
Building Height:
f-r _%ua...
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...tur.�. nf:S Ca_v„n J,i ....6n •,:T .,. ir.,-J.,..J... .. ...raX..+�'..i.. ;.
Name(_;IM4 all-D M.PA�PWPod LLC,
Name: W'JII)a1m )-nand kK
Address: 5")0 /VW /Y1-eYGCtYA i 12 NL-
Company: GHO Homes Corp
City: Port St Lucie State:FL
Zip Code: 34986 Fax:561-688-0909
Phone NO.772-873-1711
Address: Seib IVW M-erc4n-tjI_e. PL.
City: 104 ,4 (wu e, State:FL
Zip Code: 34986 Fax: 561-688-0909
Phone No. 772-873-1711
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 of construction Is,,5Z5U0 or more, a RECORDED Notice of Commencement Is required.
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[{{['1-,•T'evk.
-
DESIGNER ENGINEER: —Not
Applicable—
-MORTGAGE COMPANY:
Not Applicable
Name: _S1/utUz £na�Neerisw
Name: --
_
-----
Address:17eM�+s+
Address:
City: vmsmuea
State: e-
City:
State:
Zip: 34sar Phone 55+-amagm
Zip: Phone -
FEE SIMPLE TITLE HOLDER: _
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
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 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 pPermit Will outhorize the ermit hold% to build the subject structure
which is in conflict with an applicable Home Owners Assocation rules, bylaws Vr anScovenants t�iat may restrict or prohibit such
structure. Please consult wyith 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 ay result in your paying twice for
improvements to your prop rty. AN otice of Commencement must be re orded and posted on the Jobsite
before the first inspection.) you intend to obtain financing, consult wit lender or an attorney before
commencingwork or recor n our Notice of Commencement.
Signature of Owner/ Lessee/Co r gent for Owner
Signature of Cont c i Holder
STATE OF FLOVDA
COUNTY OF S LLt Gl e
STATE OF FLO DA
COUNTY OF CiG
The forgoing Instrument was acknowledged before me
The forgosing Instrument was acknowledged before me
this fZbayof �L 20,1J by
this L-ZRfayof 04 P 20JJby
Name of personmaking statement
Personally Known �OR Produced Identification_
Name of person making statement
Personally Known _!/ OR Produced Identification
Type of identification
T Identification
pr
rodyce
of No ubl Late of Florida 1 Rebell Dima
(Si Lary Pu - State Florida i
:(glgn
mmisslon'11���,fjempmmi5S10n GG960
JattuafY
076 mission No. `� •���tSu,�''o, (Sealj�ebecca Dlma
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ordmission 3 GG060i
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+� * Expires: January 9No'
Boded
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEXTY6LE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
II I
DATE
COMPLETED
Rev.8/2/17