HomeMy WebLinkAboutBuidling Permit Application LIAll APPLICABLE INFO MUST(� BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,��
Date: S b (12 -. `"! Permit Number: t at 05 --Os )�
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COUNTY . . RCELVec,
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Building Permit Application spy
Planning and Development Services �tttn9 0c on��t I
Building and Code Regulation Division per st.\_,,c`e C
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: Tito 1 (" et oue. -T zou.eg
PROPOSED IMPROVEMENT LOCATION:
Address: 2251 41 5 / Pi e&e' ; ,r'[ ,34`9 4/Z %71-2 S i'I v�e.rsu -dc, rt c c.
Property Tax ID#: 4/33 /30 000 O0o / Lot No. 217
Site Plan Name: R bC ) Clee5r. tiO.e/L /-160r ae bie1< Block No.
Project Name: Ri i 6 e c reesr r) '-(o
DETAILED DESCRIPTION OF WORK . ,
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CONSTRUCTION INFORMATION: ,
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_Electric _Plumbing _Sprinklers. _Generator _Roof Pitch
Total Sq. Ft of Construction: "'t9"' Sq. Ft. of First Floor:
Cost of Construction:$ /000. L. Utilities: _Sewer _Septic Building Height:
OWNERR/LESSEE Q /- ' CONTRACTOR: _ .
Name 111IJG 'a eS7flD�&G/�C t f.iPk,.. Lt C Name: %•_ G€R L 6:)+ Cc1 1
Address/900O 562-3 sti PL• Company: sacCG/eue a%oDeRCRO q1ul'
City:tYoetTN'veST Ri+A-r 'e5 State: Fe. Address:031W S /NDJl'l0.1 t veg.
Zip Code: '333 2 Fax: -- City: Fr P pf2ee State: F4.
Phone No. 77 2. - 5 .3 - .20o7 Zip Code: 3vg 52 Fax:
E-Mail: �""' I Phone No 51/ 57 v /Ugig
Fill in fee simple Title Holder on next page(if different E-Mail ?44Y@ShixeL NeG1Aibeakei vul7.Per
from the Owner listed above) State or County License FL bF 1/) A Cl e 0e/`Re
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. C 6 C OO43
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION.LIEN LAW INFORMATION:
DESIGNER/ENGIN R: Not Applicable MORTGAGE COMPANrY� _Not Applicable
Name: /t) Name: (U V )
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TIT O ER: _Not Applicable BONDING COMPA :i (.1. _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 ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU OTICE OF COMMENCEMENT."
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Signat e of Owner/Lessee/Contractor as Agent for Owner Sig ure f Con ractor/License Holder
STATE OF FLORIDA
FLORIDA
COUNTY OF ,5 �u C! � COUNTY OF
The forming instrument was acknowledged before me The forgoing instrument was acknowledged before me
thislday of Pi ft y ,20 1? by this "—day of /144 y , 201 Q by
TAk 09 /-ioDeRSoau ReGeR L. RA- eti
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification '"9' Personally Known 54. O' Produced Identification
Type of Identification %- • •-- " "cation f
P • Produced
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(Signa, re of N. Thi State of Florida) magna re •p• • •r State of Florida)
' �6 DEBORAH RAE RS'.•P •RAH RAE COURTNY
••u' - C al) , Commissionr * CammissioetOG115 (Seal)
�., * GO 11 T• tg Expires June 15,2021
s1June 1
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ley. 2/7/19
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