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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BG COMPLETED FOR APPLICATION TO BE ACCEPTED � Date: �V Permit Number: 1 Cn ECEIVED r Y � 0 ���19 Building Permit ApplicatiPlanning and Development Services County, Pgrtnitting Building and Code Regulation Division ---- 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential Ik/) PERMIT TYPE: re r© Imam I P' 01lEMEN� +CATIt+}N°. Address: 2 Property Tax ID#: I Qd� Lot No. � Site Plan Name: Block No. Project Name: Sh �h den Additional work to be performed under this permit–check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _ Plumbing _Sprinklers _Generator "oof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ Ct? Utilities: —Sewer —Septic Building Height: CONTRACTOR: Name % 4 � S Name: � \. VON Address: Itn G-t Company: City: Neviee State: Address: Zip Code: Fax: City: ' Stater PhoneNO. -! �, -b Zip Code: Fax: E-Mail: Phone No Fill in fee-simp16 Title Holder on next page ( if different E-Mail C�vina' IS 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. I UFPP! ME ESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable ame: Name: ddress: 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 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 IEEIOINOTNEBFREFRCRIOTOT YOUR NDR RAATORYEEOFINANCING CONSULT YOURNCO (COMMENCEMENT." Sig a re of Owner/Lessee/Contractor as Agent for Owner Sigh4ure of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA T�i�t/ �UGfia� OF COUNTY OF D V OF 1� The forgoing instrume was acknowledged before me The forgoing instrument was acknowledged before me this eV day of 20fif by this CR CO)day of 100,L4 20'a by / l Name of person making statement. Name of person making statement. Personally Known OR ProdI n ification 41 Personally Known OR Produced Identification 'V Type of Identification Produced Type of Identificatiop Produced �fj�� 4411 , (Signature of Notary Public-State of Florida ) (Si ature of Notary Public-State of Florida Commission No. ot�!?Yass i ggth Mohammed oZARyA s ilizabeth Mohammed oQ ; , MY PUBLIC 4� N�QTARY PUBLIC a STATE OF FLORIDA Commission No. MgYATEOFFLORIDA �-" �Comm#GG090028 Comm#GG090028 El Expires 7/2!2021 E pires REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED