HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit NumberK""' EC" "to I V1 mt—Um
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Building Permit Applica ion
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:
Address: 243 Mangrove Bay PI
Property Tax ID#: 3410-508-0313-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
Install 120V 20AMP dedicated GFCI curcuit.
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Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Alectric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 700.00 Utilities: —Sewer —Septic Building Height:
Name Regis Schreffler Name:Anthony Stumpp
Address:243 Mangrove Bay PI Company:Millenniuim Contracting Services Inc
City: Ft. Pierce State:J�b Address:9015 SE Hobe Ridge Rd
Zip Code: 34982 Fax: City: Hobe Sound State:FL
Phone No.561-843-7774 Zip Code: 33455 Fax:
E-Mail: Phone No561-718-9422
Fill in fee simple Title Holder on next page(if different E-Mail �C�S�t1�lL'
from the Owner listed above) State or County License EC 1300 1885
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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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:
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 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 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 recording our Notice of Commencement.
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Signat re of Owner/LesseeYtontractor as Agent for Owner Signat re oft oactor/License Hold r
STATE OF FLORID, STATE OF FLORIDA
COUNTY OF ��-� IC CLL}1`I/ZD COUNTY OF
The foro��i instrument was acknowledge efore me Th;fr ing instrument was acknowledgeefore me
this, �day of d�0 20by thiday of ' ')/� 20/�"j by
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Name of person making statement. Name of person making statement.
Personal[ nown OR Produ d Identification Personally Knowny OR Produced Identification
Type ofdenti� oryi, Type of Identifica
Pro c Produced
(Signature Signature • a ,fib - +�1i�i9rida
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No ublic State of Flo'da My Commission GG 049422
Commission KATHRYN POCKt§V0 Commission o orn Expires 11/21/2020 (Seal)
Commission GG 049422
OF +t' Expires 11/21/2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.