HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAB E IN 0 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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Building Permit Application
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 Residential
PERMIT APPLICATION FOR: Demolition
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.Site Plan Namec Block No.
Project Name:
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C�NSTRt�CTI�ONNFOR,MA�TIO,I .ry lr , .<:. , .,_ ^� n} �{ :T �a
itiona work-to be gerformeaT-un er•this,permit.-cneFK all appy:,
I HVAC Gas Tank FIGas Piping _Shutters Q Windows{Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq.Ftof Construction: (OS� S . Ft.of.First Floor: .
Cost of Construction:$ 1W 6Q JW Utilities: Sewer E]Septic. Building Height:
4�111NER{LESSEE } CQNTRACI"O '
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Name Name:..
Address: .aas 1 A! Company: IOYICbL% (% h1�1�2tc.iitvec4l HU-01LICKS
City:. E-L 7I Cr'Cf_ state: 1�"� ;Addie_ ss: z2Z+91 1\1W -c9 q" C
Zip Code: 31AgL4(_0_ Fax: City: R_ 44fALlerClc. t State: At-
Phone
tPhone No.,94)A%3- Zip Code: 333( I Fax:
E-Mail: r,VSIuy . C--�i'1' Phone No. `l "Le q U10
Fillin•feesimpleT.itleHolder,onnext.page(.if.different E=Mail: i�5(' O.`T'I— J?-NONE. �jM12
from the Owrier listed above), State or County License; 10-+q MP
If value:of constructionis$2500 or more,a RECORDED Notice of commencement is required.
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'$.Y: $Ri F��Y '.;'�47 "{-1�.-l:4� i f i'•S'�j.: _. 1 $5A..a, 'C.F�evF Z 'Y L p .f.. y,F Y� .�!iw^ J 1,f � ] `7.S.
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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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 peri iit'will authorize the 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.buildingpermit applications are exempt from undergoing a full concurrency review:room additions,
accessorystructures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential.use
WARNING TO OWNER:Your lure to Record a Notice of Commencement may result in your paying twice for
improvements to'Aur-property.A Notice of Commencement_must'be recorded and posted.on the jobsite
before:the first,ixsp ction. If,you intend to obtain financing;consult with lender-or-an"attorney before
commencingwork r rec rdin our Notice of Commencement.
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Signature.of Owner/ a ee/Contractor as Agent for Owner Sign ture of Contractor/License Holder
s
STATE OF FLORI A STATE.OF FLORID
COUNTY OF COUNTY---OF .�.nc�I'dto �i L-r
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The forgoing Instrument was acknowledged before me The forgoing instrument was acknowledged before me
this-,23 day of.-Q"/9NMC_Y 20 Eby this--1L day.of )mac b 20 J}by
. letICW nne Bon0 - 5eo�t-�'
(Name of person:acknowledging). (Name of person ac nowledging.)
(Signature of No ry Public-State of Florida) 4(Signat6ref Notary Public-State of FIoildai):' w ,
Personal) Known OR.Produced Identification Personal) Known OR Produced(deh"tifica'von-
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Type of Identification Produced Type of Identification Produced
Commission too. (seal$(-(EILALYNNE ( f�isslon No.
Notary Public,Macom County,MI •m;;ti R. SCOTT
_•° °= mmiSsion 8 FF 969657
- _ y =y My Commission Expires
I Rt,%ised-07/15/2014_ Acting in QQ � 71J,
County,MI %;; ;.�' March 09, 2020
REVIEWS'. FONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW - . `REVIEW REVIEW REVIEW _
DATE'.
COMPLETE
:INITIALS: