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HomeMy WebLinkAboutBuilding Permit Application r � . All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: PermIIit Number: Yq©3- 035"1 . as . Building PermitApplication 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;TYPE: P " POSED LMPRC}VEME)VT LOCATION . .' x � Address:�S i JJ.W. �y�i��� 066 C;MIC Property Tax ID#: !j!I z6 1�'- 0051 - Lot No. Site Plan Name: /b3-0 k,U! d �' C r / y1/ Block No. Project Name: Ae" Cb ;pETAILED !31}SCRIPTIQN�QF WORK, �� F � T' x�p, _ w �� ; * CQNSTRUGTIII f.}N INFQRMATIaN a s 5, n "a 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: ®a Cost of Construction:$ y ,DO®. Utilities: _Sewer _Septic Building Height: OWNER/LESSEE r ��_ Ct3NTRAC... y - a. Name L) Name: 6. ` r Address: • 41' r UC Company: vi � i City: 4�k/4 tONA&A*0 State:_ Address: O tJC_ Zip Code: 9VD JcSr Fax: City: A.V66W ltGh State:-"C—/- Phone tate:Phone No. 960c�L' Zip Code:�33AjfDy Fax: E-Mail: iD^/ '' Phone No 1rfo :''�JJ�__� /f., Fill in fee simple Title Hold n next page(if different E-Mail/�JC0e./� $; 1 �plt�s�,_A4440-0- from the Owner listed above) State or County License2�y S� 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATi01 , 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTIC OF COMMENCE NT." N7 Signatu a of Owner essee/Contractor as Agent for Owner Signature orCuntractor older STATE OF FLORIDA STATE OF FLORIDA 1 COUNTY OF COUNTY OF The forgoing instrument was acknowlecliz6d.before me The forgoing instru ent was cknowledged before me this day of t 20 by this Q day of �1� 20 19 by ?I r*-0 `b Name of person making/statement. Name of person making ssiatement. Personally Known OR Produced Identification Personally Knowny OR Produced Identification Type of Identification Type of Identification Produced oduced :1MY ob'+; DORIS FAYE MCCHESNEY. s:; o ary Public-State of Florida ommission#GG 27 44 y o m.Expires Jay24,2023 ffix/ w F 0`ti cs B ed th u ary Assn. (Signature o otary Public-Stat �eS ``oee Fay°� (Signature of Notary Pub ic- tate o Florida) �Quo},c••,Gj�°�• � Commission No. '• as Commission No. (Seal) * � 0° '•sr� oa. REVIEWS FRONT Z NG SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED _ DATE COMPLETED ev.