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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d Date: NA N N� Permit Number: Vlo "t�1 � R ECEIVED r 9.2x39 Building Permit Appli nty, PermittingPlanning and Development Services Ruitriinn»nr1 tnrlo RPnrrinti»»Mukinn 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential E w lPE rnCrryll� T 1 T>' c. aA _QonDraccn a.�no>zn «nnGnir i nrn-rir-�ni .,� : . - - ..-,s. v.•^vwa.,v.•..:. -.�v'vr..•wa-.. ....._.�v.v.....-..v. .,.,...._..,,_,. '...:..... ,-..,,___,.._�.�__._.,.__....:..-r,.._...-».y....___-,......,......>-,.._.. ____.,""y.�^"..:..._"""^"w'^,.._...,.�-._..»._. Address: ' PropertyTax ID#: 11'a���© a �a ��CZ4` Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF^VtdORK: SV NC- CC!IbSTi�y�IViti•'1 YFVIl1V'1H"1'':�VIV __ - - - =- ._..._ __.,. _..•..._ Additional work to be performed under this permit-check all that apply: —Mechanical _Gas Tank _Gas Piping _Shutters �Windows/Doors 'XI-Electric _ - rlW-11U1i1g Sprinklers _Generator Roo'I Pitch Total So. Ft of Construction: 00 Sq. Ft.of First Floor: Cost of Construction:$ �V Utilities: Sewer Septic Building Height: UVItNEfZCC}NTRACTQR Name q a1 e ,; Name. Address: Lt u a� o _ Company: City "f - State: Address: Zip Code: {q(4 (g,! Fax: _ T City: State: Phone No., T- ;4. - � o �- (c� I Q-. Zip Code: Fax: 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. SUPPLEMENTAL CON5TR _ U:CTION LiEI�itLA!!1! INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE-COMPANY: _Not Applicable I Name: Name: c� �I Address: Address 1 C ca, City: State: City: OCZ State: Zip: Phone Zip:—rN (c.S Phone: G(b —7 Q -'1,_A 6, I FEE SIM�PLE TITLE HOLDER: _Not Applicable � BONDING COMPANY: _Not Applicable Name: e Address: Address: City: City: Zip: Phone: Zip: Phone: IIOWNER/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 11 in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments. I 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 208 SINE BEFORE TME MRST !NSL3SC7lrON, IF YOU !NTEND TO OST)AMN FIA NIZING, CONSULT IIWITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." F SL. 1 1 I� Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF COUNTY OF FLORIDA�" L-y��� STATE OF FLORIDA COUNTY OF I The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this'q day of ch 20NI by this day of 20_ by I� Name of person making statement. Name of person making statement. I (� Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced L ID (® Produced (Signature of Notary Pu ic- EANNPIMAIKI ti3C 02202; ($ignature of Notary Public-State of Florida) <es::��•.: MYcoM1w11$514N# t1"v.2t)2 1ti 0 Commission No. CSS-®. SE97jhEs��en r'bllcUns a: ( c�,; Cd'mmission No. (Seal) c`: Wilde I 1! !� RFVIFWS FRONT 70NING SUPERVISOR I PIANS VEGETATION SFATURTIF MANGROVF COUNTER REVIEW I REVIEW J REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE �( COMPLETED 'Rev. l ev. 2/7/19