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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED O n�
Date: G SCABN1NED Permit Number: 5
ST LUCIE COUNTY =RECEIVEDBuilding Permit Application Planning and Development Services , ' 1 c�
Building and Code Regulation Division OVli�wll 1T C� T5
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Other
PROPOSED IMPROVEMENT LOCATION:
Address: 3163 Hammond Road, Fort Pierce, FL 34946
Legal Description: 30 34 40 S 200 FT OF N 245 FT OFN 1/2 OF NE 114 OF SW 1/4-LESS RD R/W AND LESS AS IN
OR 459-2756-(5.20 AC) (OR 3734-2525)
Property Tax ID #: 1430-311-0002-000-3 Lot No.
Site Plan Name: Missionary Flights International Recreational Vehicle Park Block No.
Project Name: Missionary Flights & Services, Inc.
Setbacks Front 20 Back: 10 Right Side: 0 Left Side: 10
DETAILED DESCRIPTION OF WORK:
Construction of dumpster enclosure along with all site improvements associated with Missionary Flights
International Recreational Vehicle Park.
u
❑HVAC ❑ Gas Tank ❑Gas Piping
DElectric ❑Plumbing ❑Sprinklers
❑Shutters ❑ Windows/Doors
❑Generator ❑Roof = Roof pitch
Total Sq. Ft of Construction: N/A - Dumpster Encl. Sq� FFtt_.� of First Floor: N/A
Cost of Construction: $ " (%«o ww> Utilities: LJSewer ❑Septic Building Height: N/A
Tri/
OWNER/LESSEE;
CONTRACTOR "
Name Missionary Flights and Services, Inc. / JosepN H. Karabensh
-Address: 3170 Airmans Drive
Name' Doug Davis
Company: Richard K Davis Construction Corporation
City: Fort Pierce State: FL
Zip Code: 34946 Fax:
Phone No. (772) 462-2395
Address: 4205-Metzger-Road
City: Fort Pierce State: FL
Zip Code: 34947 — - Fax: —
Phone No. (772) 461-8335
E-Mail:joeK@missionaryflights.org
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: ddavis@rkdavis.com
State or County License: State - CGCO13084 / County - 8215
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEIMIENTAL CONSTRUCTION LIEN'LAW INFORMATION: '
i
DESIGNER/ENGINEER: _✓ 'Not Applicable
Name: &gin.erin9 Design 8 conswction. Inc,
MORTGAGE COMPANY:
Name:
= Not Applicable
Add reSS- 10250 SW village Parkway, suite 201 _
Address:
City:. PCd s1•Lacia State: FL
Zip: 34987 Phonen2ra2-24ss
City:
Zip: Phone:
.State:
FEE SIMPLE TITLE HOLDER: = Not Applicable
Name: somaas—na,
BONDING COMPANY:
Name:
=Not Applicable
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 permit will authoriiejIne: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 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 inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recordiii our Notice of Commencement.
iiiiii—
/2., L, r-r4giva _
Signature of Owner/ L see/Contractor as Agent for Owner
Signature ctf Contractor/License Holder
STATE OF FLORIDA�.Wut,
TATE OF FLORIDA
COUNTYOF
COUNTYOF
The fo oing instru ent was acknowledged efore me
The forging instr' meet was ,acknowledPed before me
this �'s'tiayOf.MUCV) •20Vby
th,s dayof'-_'� 20l_.by
_Rvadleu G� rte�sl�
S
Name of perso making statement
Name d f perso making statement
Personally Known OR Produced Identification_
Personally Known' ''Y OR Produced Identification
Type of Identification
Type of Identification -
Produced _ Y\1 Oki
Produced
(Signature of Notary Public- State Florirf;seltrida KL seste
(Signature of Notary Public -State dFlo id
ARYPUBUC
Commission No. TE OF FLORIDA
,,.a.,, 0 RAKEBHEfl
Commission No. T•N` ' y U
Noltry PY1011�, State of Florida
. CorrinN FF983414
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SUPERVISOR
PLANS
VEGETQ
COUNTER
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Rev. 8/2/17