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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ( � Date: 5-2 4,--(-61 Permit Number:( `O S ,/�/63� AIIIIIIIMINI -�.., RECe1Vi;® � .1 '' MAY 2 41619 F L C, R 1. I? A -_ Building Permit Application Qermittin9 Deparfimw, Planning and Development Services St.LuCie County 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 IMPROVEMENT LOCATICINS °ov.: a Address: 7 573 ,12Ar Property Tax ID#: tit 9- (Q-01 o1 - 0034-00015 Lot No. Site Plan Name: Block No. Project Name: , Q AILED DELSC«RIPTI®N CrWORK? ° ° ° . ° 1 c©1( . 1N LAACLOW no-ta_V_e_MQAA)+- — ( {1 r—f- (AR via 00_3 CONSTRUCTION INFORMAT10No mem 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: Sq. Ft. of First Floor: Cost of Construction: $ 5j Q-ao• Utilities: _Sewer _Septic Building Height: ®WNER/Lti:SSEE° . CONTRACTOR? ° 0��Name �LVI ._ Name: Address j D h24r Company: City ' -Pier' - State: Address: - - Zip Code:4C ( Fax: City: • State: Phone No.21�� 3 V5 9t (oci Zip Code: , Fax: E-Mail: e." / J'1.LPcha (J YV1 Phone NoFill in fee simple Title Holdr on next page( if different E-Mail from the Owner listed ab+e) 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. 1 , EOPPLEMENTGL CONS V RUCTICIN UM INF®RMA Eg --_®— -- -- —� -- 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 ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WIT YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." — Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY . COUNTY OF OF � IJLle The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of , 20 by this_j day of '1'1!1 , 20 I by 16-t-gk51-1/Ul }SCt`J0QI') Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification ✓ Type of Identification Produced Type of Identification Produced F1/I,)L 2, � ,l (Signature of Notary Public-State of Florida ) (Signature of Notar Public-State of Florida ) Commission No. (Seal) Commission No. . ` ELAVVAUGHN �p�Y PUbT�i °i° `�,�State of Florida-Notary Public --- *E Commission # GG 27007 % o,„° ,' My Commission Expires � ber 2, REVIEWS FF; e.,r : ° • PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 2/7/19