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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi 4 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: `l —� �(� Permit Number: �V 7 ^ � 3 ' RFC Building Permit Application a APR er 12781E Planning and Development Services t IlIg D Building and Cade Regulation Division sLV`!e CPar y `CANNE 2300 Virginia Avenue, Fort Pierce FL 34982 BY Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x 7_I trip rtnl PERMIT APPLICATION FOR: Building E PROPOSED:IMPR©VE_IVIENT LCg OTION Address: _ 2—IO2_t)cn+ A)In e D r . Property TaxlD#f:_Lot No. 2,7i1� Site Plan Name: Block No. Project Name: Setbacks Front rJ Back: — Right Side: 1 Left Side: 32_• -4 ;DETAILED DESCRIP t10N<OF WORK _dill '•. is t 4 Construct Single Family Residence Bedrooms 3 Bathrooms Garage I CIO i, INFORMATION:: '.E:. • ��l L_`'.JHVAC L,JGas Tank "Gas Piping 9Electric OPlumbing ZSprinl Total Sq. Ft of Construction: ADS q Cost of Construction: $ 100.000 1561 %/J)— 75 Shutters ❑✓ Windows/Doors Generator Roof = Roof pitch S Ft. of First Floor: _ Lltilities:Sewer Septic Building Height: 4Q,INNER/LESSEE CONTRA NameGRBK GHO Meadowoad LLC Name: William Handler Address:590 NW Mercantile Place Company: GHO Homes Corp City: Port St Lucie State:FL Zip Code: 34086 Fax:561-688-0909 Phone No, 772-873-1711 Address: 590 NW Mercantile Place City: Port St Lucie State: FL Zip Code: 34986 Fax: 561-688-0909 Phone No. 772-873-1711 E-Mail;rebeccad@ghohomes.com Fill in fee simple Title Holder on next page (if different from She Owner listed above) E-Mall: rebeccad@ghohomes.com State or County License: CBC051145 IT Value of constructlon is $2500 or more, a RECORDED Notice of Commencement Is required. i is DESIGNER ENGINEER: _ Not Applicable Name:�VrieL1L �Pq;rree.4!na Address:++asaswrt� �'—� City: Pmistuda State: FL Zip: xesr Phone satazsaers J, .,t �1 �•n:. �,v i` �e'� k.$•_�y�.1 4� �y' MORTGAGE COMPANY: Not Applicable Name: Address: City: State: _ Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Name: Address: Not Applicable 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. Lurie County makes no representation that Is granting a permit will authorize theSermit holder to build the subject structure which is in conflict with an applicable Home Owners Association rules, bylaws or an 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 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. Lucle 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 t your property. A Notice of Commencement must be recorded and posted on the jobsite before the first i spection. If you intend to obtain financing, consult with le der or an attorney before commencin w i k or recordin our Notice of Commencement. Signature of ne s e/Contractor as Agent for Owner Signature of C a r ense Holder STATE OF FLOgjD COUNTY OF S -� Gf C STATE OF FL7DA COUNTY 1 U� • U.t OF The for oing Instrumentwas acknowledged before me The for going Instrumept was acknowledged before me %ay this(�day of Ll ,o•r jl1 / 20M by this of � 20.4 by 1.Ul11J4 ) i7R14rbPf P'llo e'e Name of person aking statement Personally Known OR Produced Identification _ Name of person making statement Personally Known LL OR Produced Identification pe o tiflcadon Type of Identification Produced — Ign Notary Puhllr orldaQtebeCO GGBvu— 6 (signa of Notary Pu li fate of Florido..., Rebecc �b@yPf�di;�, ,�Pe;?.P/16.y% �ISSIen� Commission No. a, JenU3ryo ,Np1 Commission No. n (P Ifcs=pl vs IreS. EBopndedtbtu eS'.SI ',° '-,,3Fa, Bonded thru . ••o°` REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 A GUblsory i 9, 2021 a Notary