HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUSTBECOMPLETED FOR APPLICATION TO BE ACCEPTED rn1
Date: G?f� • / 9, Permit Number: R IL
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___ Building Permit Application FEB 12 2019
Planning and Development Services Permitting Departmen
Building and Code Regulation Division
S t. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: �) �m �1 ,VC
.PR OPOSED INPROVEIVIENT LOCATION
Address: S L�S-5 Cry::I �
Property Tax ID#: OZ z("Z " �13�-OCJC�-gi Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK
CONSTRUCTION INFORMATION._
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE CONTRACTOR
Name c* V_ Name: Uy", k C,,,&"
Address: 9gfS5 t_-� 4rble_ 1� Company 1�` L&-C�:2L)e
City: 4k- r1i�crc�P Stater Address:7[o'75
Zip Code: = �[�1gZ Fax: City: .r State:-�-L._
Phone No. "ll�- ` 3�t- 3�(�Q2 Zip Code: Jtrl Ct rj Fax:
E-Mail: Phone No "l'7'2-P
Fill in fee simple Title Holder on next page(if different E-Mai1-Rcto� ���,C,1s� LoN•c� ,YET
from the Owner listed above) State or County License LPC-I!.45-72<4Z,
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.
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 Noti mencement. 43
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Sign re of Owner/Lessee/Contractor as Agentris
f vgrt Signatur of Contractor/License Holder 2t tL
STATE OF FLORIDA ' �� STATE OF FLORIDA m
COUNTY OF ¢ t COUNTY OF co
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The for oing instru n was acknowledged efo m m The for oing instrum was acknowledge before a >-LU
this�day of 20�ty this �� day of 20 by
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• • 'a• :de � sa• ,oyo
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of I ifi ion Type of I ion
Produced Produced
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(Signature of tary Pub ic-State of Fldricla) (Signature of Not Pu ic-State of Florida )
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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