HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED y
Date: I Permit Number:
RECE1%VED
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_ Building Permit Applica. ion JUN 13:2019
Planning and Development Services Permitting Department
Building and Code Regulation Division CJt. Luci Dunt FL
2300 Virginia Avenue,Fort Pierce FL 34982 y,
Phone: (772)462-1553 Fax: (772),462-1578 Commercial Residential
PERMIT TYPE: rn FIX 1116i"
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Address: .
Property Tax ID#: � IPJ Lot No.
Site Plan Name: Block No.
Project Name:
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4clitional".workto be performed under.this permit—check'a'll'ta at apply:.
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-' -M- anical '. Gas Tank _GasPipini; i:• 1Shutters .-Windows/Doors _
„E'l'ectric �Plurribing _'Sprinklers:' - �Generator _Roof, Pitch„
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otal;Sq F#'if Construction: :''.S'q!:'iFt:ofi�First Floor:
Cost:Qf.'Construction:$ Utilities: Sewer _Septic Building Height:
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Name `r,O(re Name:
Address: 3a8. JU . .S3 S'i'..;'... Company: 06��c�c,
City: �a J efGC State: Address: (O! �-
Zip Code: 3 't Fax: City: -C/+— Y-'i of Lz Stater
Phone No. 33a — 018S Zip Code: ,3ggs ( Fax:
E-Mail: Phoneo
Fill in fee simple Title Holder on next page if different E-Mail larido, . �►�. �.
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.
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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 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."
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Signature of Owner/Lesse Contr r as Agent fo ;� Signature o Contr ctor/Lice se Hold r
STATE OF FLORID STATE OF FLORID
COUNTY OF COUNTY.OF
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The for oin instr e as acknowled d before ° The forgoing instr nt was cknowledge�J fore
g g �" � �—
this day of 20 by m N his day of 20 by c 0
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ASM NM
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Name of person making statement. 1- 0 ame of person making statement.
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Personally Know OR Produced Identification " ersonally Known C/ OR Produced Identificati rt=
Type of Identification !N pe of Identification
Produced Produced °-y°
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(Signature of Not Public-State of Florida) (Signa rre of Notablic-State of FloridaV 91
)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19
Fort Pierce Utilities
206 3 6th Street
Fort Pierce; FL 34950
Telephone No. (772) 466-1600
05/16/19 1:53PM
Receipt #: 0441905160100003
Customer #: 257316
Location #: 10007890
For: SANDRA F SANDERS
Payment Received: .290.00
Amount Tendered - Credit Card: 29p,.-.00
Authorization Number : 357251
Paymentwillbe posted: 05-16-2019
Register: CASHIER 91
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