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HomeMy WebLinkAboutBuilding Permit Application c All APPLICABLE�I INFO MUSTQBE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ' - l '` U-I - Permit Number: Lq0111-- 0 r-'-' ANOMMOMENNUMMI RECEIVED :-COUNTY "':.n. APR 18 2019 F ;L 0, R .I D A m�ttin9 DePa tmCnt 1111 Building Permit Application St.Lucre County 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: PROPOSED nIMPROVEMENT� LOCATION: Address: qat l' `�'c'-2-fie-' NI_ Prpperty-Tax.ID it: 33Y7 70�- - nom — coo- 7 Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: --2)C004\r\V 14\-OL 50c Lem C CONSTRUCTION INFORMATION: ,I Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors 1 —Electric Plumbing _Sprinklers —Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ I0C0 % OD Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: _ Name EG.QLAN CQ-0 t e e u S Name: t4 i00-Ae YT Address: Tic* _ f e..L QC k)12 Company: ' 4 I ' Ta ' 1_1110. 4-41101 A► City: (!% Lowe e to * - State':Rd Address: -5clo Nw vtgz-lsj 0.tynk. l' ^UH.9 Zip Code: 34.91..$lo Fax: City: L . State:lq Phone No. 4:17U''4;1 5--3 3 7c-1 _ Zip Code: j- � Fax: E-Mail: Phone No 11r1•4&'112Y Fill in fee simple Title Holder on next page(if different E-Mail Vtc - ri 071 + q3 fl from the Owner listed above) State or County License . 1 1. &B7�`-(' If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 9NCI 53s If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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 represu sentation that is granting a permit will authorize the permit holder to build thesubject 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 0, THE JOB ITE BEFORE THE FIRST INSPECTION.. IF YOU INTEND TO OBT• N FINANCING, CONSULT WITH Y I,•R LENDER I ' AN ATTORNEY BEFORE RECORDING YOUR NOTI c 2 F COMM -•CEMENT." v ign. ure of Owne sse. Contractor as Agent for Owner Signature.j'ontractor/Li=nse .Ider STATE OF FLORIDAL, - STATE OF FLORIDA COUNTY OF C9;! (.L(,cf e COUNTY OFOF Lu ` The forgoing instrument was acknowledged before me The forgoing instrum nt was acknowledged before me this ( Y day of Ret_ ,20 Lc-9)y this (day of ice__ ,20 (7)by ('<,2-v\ cm CTc-PP,In,c K-e,tin r) 6ce-e1m Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification / Produced '1 Produced ( 0C._; " ttty--- ___/------ EiVe5e.ji______..---- (Signature of Notary Public-State roof Florida) (Signature of Notary/ �Public-State of Florida) Commission No. v ` °vC S(Seal) Commission No. ? —07 © (Seal) 0+ J 6-�...- NoWP , ELLEN - �vv REVIEWS FRONT . g,: Stet �m a YN�� VEGETATION S •i 111 • 3; COUNTER =:,�, .- - Co nmR IEWGG '7o REVIEW ��,'pp�,'` ;State f ",. •G H I` /-= ii1 ' i'a- . 'ubic o;,,,,,;r� ' • res :;.viii ,; om fission # GG 270079 RATE � Rr �October 22 2pZ ',? �o;: My Commission Expire: RECEIVED �u„a October 22, 2(122 DATE -- r.. �.�, • COMPLETED ley.2/7/19—