HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO M ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3o Permit Number:.-- ,
REG.-
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Building .Permit Appli ation APR 3 0 2019
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 t. LUCIe �O t�/, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial
PERMITTYPE:
PRCipPOSEI INPFC}1EMENTuLOCATION .v
Address:
Property Tax ID#: O s Lot No.
Site Plan Name: 4 Block No.
Project Name: A 91564
DETAILED QESCRIPTION O� RK
T; . .:,.. �.: : . ti� s
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P- ice T qD/ 0.500
7.,
77
777771
�GONST UCTIQN INFO'RMATIOIU ,, 4
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Additionali,work to be performed under this permit—check alfjtliat apply:
Mechanical —Gas Tank —Gas Piping -... ._._:Shutters —Windows/Doors
lectric Plumbing —Sprinklers Generator Roof Pitch.
Total Sq. Ft of Construction: 70-0-0 Sq. Ft. of First Floor:
Cost of Construction: $ /, 7-Ta. Utilities: —Sewer —Septic Building Height:
OINNERJIESSEE, CQNTRACTOR
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Name
&.JdA) &1✓ECS/y Name: r
Address: 7100 6�-.i'LA-,4C i1? 57'• Company:let d
City: State:— Address: 6/I
Zip Code: Fax: City: State:�z
Phone No. -7gt:— 5-/a-4q 9 f Zip Code: 3Z 91.11 Z Fax:
E-Mail: VO r-d--Pqa 40 S/on ;Wrna—S , eori'I Phone No. 77z—J4/3 r/2 4Y—1
Fill in fee simple Title Holder on next page(if different E-Maila1a GEzGIr,& G 42z�/�.
from the Owner listed above) State or County License ✓?/�03
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.
SUREPLEMENTAL CQNSTRUC 10 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 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 Re qti a of Commencement may result in your paying twice
improvements to your property. A Notice . ` ncement must be recorded and posted on the 'o iir ;s • •.,
before the first inspection. If you.intend t ' ancing, consult with lender or an attorney befor
commencingwork or recordin our Noti
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Sig ature of Owner/Lessee/Contractor as Agent N = Sigffatureoi Cont ctor/License Ho er z
STATE OF FLORIDA $ STATE OF FLORID pig00
COUNTY OF C� x COUNTY OF a�
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The forgoing instrument was acknowledged befor a The orgoing instrument was acknowledged before m � .
this day of 20A by this day ofD1e r-- ) 20 ° by
Name of.person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification r
Type of Idei o Type of Identf€i tion
Produced Produced - C
(Signature-of Not Public-State of Florida) (Signature of Not®r Public-State of Florida )
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.