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HomeMy WebLinkAboutBuilding Permit Application I All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED j Date: o Permit Number: 1 '\v b © L l2ECETVED '. MAY t 4 7019 cOu N T 1r" E"'L 0 R 1: a A._ PeCmlttln� Budding Permit Application st,LU4iC 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: i� �k..;:.-� �, d 6 e � ,. � f �,. ysY �atf �p ♦✓�2" .i �b F�i 4� Si� � v.5 � ��-,�� Address: 57 7t T(�.v. tj u S�PT �i i e�c1- - t F L q Property Tax ID#: 3(j t o \3 ' 7 Lot No. 3 1 i Site Plan Name: Block No. Project Name: ,.. --co'�� i � "A'�'9 � '" i�,�.i +,� y,;,;yy;� ��� - ✓.sem *a - / �� ' I Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank a Gas Piping _Shutters _Windows/floors _Electric _Plumbing —Sprinklers _Generator r( Roof Pitch SI" Total Sq. Ft of Construction: � �L Sq. Ft.of First Floor: Cost of Construction:$ /4 X)1) Utilities: _Sewer _Septic Building Height: I Name��� TQC c✓t o� 1�: Name:ç \c tv tette Address:571 q l<t -Iety L ty- Company:—r_ ttc-4'- City:' -L e zi c . State . Address: 3 Siw &tE, C\&S Zip Code: Fax: City: Q cs c c Sc * LL i L State: L. Phone No. I Zip Code: Fax: ' i E-Mail: Phone No"11 _�� D-i5 t5 Fill in fee simple Title Holder on next page(if different E-Mail S(i0( 5 - Shoo. c-c3�"1 from the Owner listed above) State or County LicenseCc=-t-(33 11 0 i If value of construction is$2500 or more,a RECORDED Notice of Commencement Is required. I I If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. j i ms: 1 DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable I Name: Name: 1 I Address: Address: City: State: 1 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 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." Signature of Owner/Lessee/CO tor as Agent for Owner Signature of Contractor/Licen-6 .- STATE OF FLORID STATE OF FLO ,, COUNTY OF COUNTY OF Thef.c. gping instr n nt was acknowledggfl,pefore me Thq..tprving instrum t was acknowledg efore me this` day of 20 l'1 by this day of ,20 J'by ( danci lit Lei Nand L )I Name of person makings tement.U Name of person makings tement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced LexaJMCOLIL., i (Signature of N t ry Public-State of Ftn ida) (Signature of Note("Popu a ublic-State of FI i a i ock pe BRANDY MOOR { g 'dun) ®RANDY MOOR! Commission No. °,SI ;r e I Commisalon#GG 10 839 q ��� , �.�e }Commleslon#GG 1028 9 lC�2U ) Commission No. I+ al 1. .,, y , Expires May 9,20 1 al. �T Expires May 9,2021 y5F M e Bonded lhru BudpotNotary S Mhos yam, or M1 !or 11.09. esndod Ihru Bator Notary 4414,os REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE I COUNTER ' REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE I RECEIVED I 1 DATE COMPLETED iev.2///19 , l ! !