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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE.INFO MUST BE COMPLETED FOR APPLICATION TO-BE ACCEPTED Date: Permit Number:.- r s Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(771)46Z=1553- Fax:(77Z)452=1575 Commercial- Residenfiat PERMIT TYPE: F.IPOSED�IIVIPRi}11Ei1�lEli L�Ci4TI3 � r 3 n �� � 1s Y ,s�'.- rest Address: // 1Pe J Property Tax ID#: ,3 © 6U ` ©�' �® Lot No. Site Plan Name: Block No. Project Name: ri.e."`+' "� 2•cu ���1N*'5 + 3 7 {�: �'^t 1+re l; zaa y,} �,`. g z, � ti�; -:.}- RE`fAi ED DESCRIPTION1l=,V1I41K 4> h ,Q f w;. � M �k �1 `�.,` h � �z _ ..':12`S`nt e C M � .lS S 00 j S e <'.:>:,xT .'s 1 y'�`c{ �Ye ��/(�� } >nvf�?;�.•.� {y��,y�F S� ��Ny't� � �,k �.�, x � 72.--,,.a" xF.�J;��a )xn l- � i f^�t.t �n ti�"..0 ti=cel-¢ru 2'�`vC_ Additional work to be performed under this permit-check all that apply: X 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 .. , fu' H'eigDht- Kx �nY 411""""D� i, A G R ; r s�e . Name: ThokAs E Koe, ID roti ep Add re_sss 3 d' Zip Code:- Fax: City/ . k, Phone No. 7 - Zip C`o'de 3 a c: g2 2. E-Mail: Phone Phone No 7 - - Fill in fee simple Title Holder on next page_ (if different n� C from the Owner listed above) State or Co ty License 17 n�° I5 - OR 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: �N �� ?`k r"�+��.'�#.x.,r:n?.,2�'��a(`.S'f.'N.�-t�f '•F^" s k-'�1 ..-'�'`` r�'i rS�""+.�+-e'C:is y,.>t t .�.� i x+v - � •' �.,'t�'�� .�c`�r r .�s�a[�r Yn as'�°r-f�^,,,� ���,a ,.' �.�.ti ,:.,.�..... .. _. . s..4'�vn:s 3. i�-..z,., ..,;}3;"`rx�`.t�§ t���R�„�`S., ,.a''.f„ r.... �s.n�.<,x.r& <..y °�_z,....L.'�a_'•��i,',t...t,3�< .,. 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: Narhe: Address: Address: City: City: Zip.:, Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT:Application-is-hereby made to obtain a permitto-dothe-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 orprohibit 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 NOTICE OF COMMENCEMENT." r Signature o Owner/Lessee/Contractor as Agent for Owner Signatu of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTYOF The forgoing instrument was acknowledged before me The Io going instrument was acknowledged before me this � �'day of .20 by this l day of 6 ,20_j�L-by Name of person making statemen Name of person making statenvent. Personally Known OR Produced Identification Personally Known OR Produced Identification Type-of Identification Type of-identification Produced Produced (Sign ure of Notary Pubti State of Florida (Signature C II EXPIRES: 2 bOF,Q I' �j 11i1i Commission No. tpr (p INGRAM �Ommissio F°F�+oP 31)s RAHMING Public ' MY COMMISSION#GC- IRS): G 275060 i+r . .. EXPIRE Dece REVIEWS FRONT 6N ��'" WimilAderab Irs LANS VEGETATION SEA TURTLE MANGROVE COI NTE REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.2/7/19