HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST B(ElCOMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: J Lj2 � �,�"'F �r- Permit Number: i go i-i o
RECEIVED
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Vkl_ .. Pe m ttingDepartment
mizartiolassammumagm Building Permit Application Lucie County
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 I
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: b.."15 A Vk rcc <?r e -€4- .. ;c----L 39 ci k`3.
Property Tax ID#: 34-tlo- 503 -- c 33' - J -,'7 Lot No.
Site Plan Name: Block No. L
Project Name:
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DETAILED DESCRIPTION OF WORK: ” --- -
kc_- (0 S-- 51,-,; J r5v_— •1, cc,,;,.,\e - PrP, n.iCa 1 'ck Uncl-el/ fay44e4
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply: j
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
Electric _Plumbing _Sprinklers _Generator Roof
�2, .--..:Pitch` _
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Total Sq. Ft of Construction: Z.bGOOSq, 0. Sq. Ft.of First Floor: _
Cost of Construction:$ Ig000.CO Utilities: _Sewer _Septic Building Height:
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OWNER/LESSEE:.: ` CONTRACTOR:
Name,S k'‘r ley_ A�C 1��A Z t Name: 10-,,,Ac . 2 LA) t' 1't4
Address: �0,g� AA-cat\:e-; Vk. Company: 3(ns<�i;N2. OA0c n t-LCJ
City:f, e ; •e<Ct, State L- Address:(Ci *73 S-1.,1) Cs-lac.,n e (z k�S4-
Zip Code: '' Li 9 g-,4- Fax: City:7s3(,r 5 r�,1k L11 L;-Z„ State:E�,
Phone No. Zip Code: 3 -t l S7 Fax:
E-Mail: Phone No'17?- - ,?-60 - i5.(:35-
Fill
S.(:3SFill in fee simple Title Holder on next page( if different E-Mail .Skc J- i i nLJ!�c:-i,^S Cg ycL GC ;vu e-(1
from the Owner listed above) State or County License C I i ( 1 o
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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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address: I
City: State: City: State: 1
Zip: Phone I Zip: Phone: I
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address: 1
City: City: I
Zip: Phone: Zip: Phone: 1
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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 0:TAIN FINANCING, CONSULT
WIT JJR DER OR AN ATTORNEY BEFORE RECORDING-Y• .R-NOT OF COM A•NCEMENT."
L---')i-,_ ________ C,
1 Signature of Owner/Less ontractor>assAgent for Owner Signature of Contractor/License "o der
STATE OF FLORID , STATE OF FLORID�n ��I .
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COUNTY OF ` � COUNTY OF r�l fir)
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The erg,ing instr ent wa acknowledge wing me The ing instr ent wa acknowledg 1pefore me
11 thi* ,day of QiJ , 20 I 1 by tis CC day of 20 11 by
PD\and Al\se land OW/Name of person maki statement. Name of person makin statem
Personally Known OR Produced Identification Personally Known 'N OR Produced Identification
Type of Identification Type of Identification
Produced Produced
\ Cmc c \c
(Signature of Not ry Public-State of Florrcstj . BRANDYM00-E (Signature otary Public-State of Florida) 1
1 _ �j2 4 ��... Commission#.GG 102839 G, .p0 .•:,49e, BRANDY MOORE
Commission No. nn�O20J I e' k G6 102 ''.'0r Commission#GG102�9
7.J ) ommission No. ,� I
. i� cr Explras May 9.212c u• ..-
� 2)2
lt'or F�o� Bonded ThruBudget Notary,°Mco6 �' arc Expi los May 9,Notary
"t'opf Bonded lhruBudget NotaryS Iwo
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED '
DATE
COMPLETED '
Rev. 2/7/19
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