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BUILDING PERMIT APPLICATION
M9 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: IDU Permit Number: I © - O M EFEB D Building Permit Application9 Planning and Development 5ervicesBuilding and Code Regulation Division mitnng 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x PERMIT APPLICATION FOR: Building n I'_iPROP©SEDhIMP.ROVEMENT,LO'CATI(DNc 1 Address: _ctlD 3 3 Kno I l w oc)d Lh P+ Pig r(Q a(:HNNE® BY Legal Description: rnWQd0WMd-LLnI -P'Ve - 10-F 5 St Lurip CoLlnb. Property Tax ID #: t3a S - 00 I - o(DtD3- 000 - i-1 Lot No. 5 Site Plan Name: Project Name: �1 Setbacks Front Back: ZL4!2 Right Side: 20'0 LeftSide: 2-O Block No. fDETAILE© DESGRIPTIQNgOF WORK_ ` : '• i ' Construct Single Family Residence Bedrooms Z— Bathrooms �j Garage CO_NSTRUCT_ION_' INFORMATsIO,N:', i iona wor to e e orme under is perms -cec a apply. EJHVAC 11GasTank ❑Gas Piping In _Shutters Windows/Doors Electric OPlumbing Sprinklers EJ Generator Roof Roof pitch Total Sq. Ft of Construction: 32P(C5 S Ft. of First Floor: �329IJ FI Cost of Construction: $' 3Q�911 . j utilities: C2 Sewer Septic Building Height: ;OWN,ER/LESSEEt ' 1 :COKIT—IMCTOR t`• NameGRSK GHo Meadowood LLc Name: William Handler Address:590 NW Mercantile Place Company: C7 P—AK- Ca. V Aoe"-Co City: Port St Lucie State:FL Zip Code: 34986 Fax:561-688.0909 Phone No.772-873-1711 _ Address: 590 NW Mercantile Place City: Port St Lucie State: FL Zip Code: 34986 Fax: 561-68M909 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 vdiue or construction is $zbuu or more, a KECUKULU Notice or Commencement is required. -ei;6l �I �Y'v- aw .n:. , _rr� q uy.�• � a.... ;•nn-.. i qp5 i �� ; i;< a - L_hf, : �'?_+Y:.>,q�, �°�5� DESIGNER/ENGINEER: _ Not Applicable Name: £na;rleer7na Address: 1isuswRImII.si .e...._a 'Yv � •.r •c `p^'� r ,(u �F ..i' ,.. MORTGAGE Name - Address: � �:. , � . i v '., on a��'y%t- { t�rt.-�a .. , � ti��. rF�iA�ila�!Ea''•w.� , ,�+i COMPANY: _ Not Applicable City: PUGs1Lwil-- State: -FL Zip: ,46a7 Phone 581.629d875 City: Zip: State: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable Name: Address: BONDING COMPANY: : Not Applicable Name: Address: City: Zip: Phone: City: 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 represent tion that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with an� applicable Home Owners Assocation rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult w th 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 I your property. A Notice of Commencement must be recorded and posted on the jobsite before the firstspection. If you intend to obtain financing, consult with le�der or an attorney before commencing wk or recording vour Notice of Commencement. Signature of ne s e/Contractor as Agent for Owner Signature of C ac rWnse Holder STATE OF FLOg�D/ COUNTY OF 4- . - Gf a STATE OF FLOgIDA 4- Ltd UC _S - lM COUNTY OF , The forgoing Instrumqnt Vas acknowledged before me The forgoing Instrume t w s acknowledged before me P this? day of tq 20JI by this day of 201f by 1eJ III )'g M RA- Y, W 111 7 et wi I-} a wl I.e,. Name of person aking statement Name of person making statement Personally Known OR Produced Identlflcatlor Perso all Known OR Produced Identification T ro edCD A g cm o pe of ication Pro ced b o •j Cco, U O C J Z d A �:y I of Not lic• State of Florida) of 9 azure ublic- State of Florida I 8 ,; a 0 Commissio (Seal) U `$ Commission Seal (Seal) REVIEWS FRONT ZONING 5'(31 fi. OR PLANS VEGETATION SEATURTLE lvIXftW _COUNTER REVIEW REVIEW REVIEW --REVIEW— —REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/Z/17