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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: DOM �° Permit NumbEr O. IVCD QUA a 6 2019 Building Permit Applicdepartment Planning and Development Services FL Building and Code Regulation Division County, 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: 1 � � PROP05E©INPfO„VENlENT LOCATION s Address: ,'1 �/� Property Tax ID#: 3 �O_ - �D d - (/(/ Lot No. Site Plan Name: ,p 1. Block No. Project Name: h01 n (1> ' Y r r 1 +e A. DETfLED DESCRIPTfON OF WORD r l R. F L v-e R V tLc v ., ej COs „ RU, TIONINFORACN 14 b � Additional work to be performed under this permit-checkall.that apply: _Mechanical _Gas Tank _Gas Piping<; Shutters _Windows/Doors Electric tvPlumbing _Sprinklers:' _Generator _Roof Pitch Total Sq. Ft of Construction: "Sq "Ft. of First Floor: Cost of Construction:$ 25'0, y Utilities: —Sewer —Septic Building Height: OWNER/LESSEECONTR,4CTOR ws_.. _ . �.. Name E v A.)VX., Name: Address:_ 6gbS ICV �V Company: City: EoY i' 0 CVr� State:"fZ Address: Zip Code: 3'lq �6 Fax: City: State: Phone No. �r—�a— �� 8 - "� 6 a j Zip Code: Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License 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. TRUO: CTtON Ll: INSUPLEVENTAC =02MA1tN. 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 financin , consult with lender or an attorney before commencing work or recording our Notice of C ent. �� z?o9,d�i •�3 Signature of Owner/Lessee/Contractor as Agent for Own ?S_ig ture of Contractor/License Holder STATE OF FL ORITE OF FLORIDA COUNTY OF NTY OF The forgoing instrument was acknowledged before me orgoing instrument was acknowledged before me this_J�:_day of d n RAA 20/ byo, day of 20_ by o i"''1 A n v e � Name of person making statement. a Na of person making statement. Personally Kn OR Produced Identification Personally Known OR Produced Identification. Type of Identificatio Type of Identification Produced 9 'L Produced (Signature of Nofdry Public-State of Florida) (Signature of Notary Public-State of Florida ) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.9/26/18