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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: (Q Z Permit Number: i , �.-- ,;� RECEIVE aa Gnu°' 7 r F Building Permit Appl cationm 17 2019 Planning and Development Services Building and Code Regulation Division Permitting Department 2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie Covnty, FL Phone: (772)462-1553 Fax: (772)462-1578 Commercial PERMIT TYPE: S AFe-e,) k1�,l. r' PRO: OSED INPRRA EMENT C} ATIfJN; (� Address: ( O eevl l eociCx F-1 3 C/ 7 Property Tax ID#: I N 3 J - -70 Z 00 12 ' 600- C1 Lot No. Site Plan Name: Block No. Project Name: ©ETAILED DE=-SCRIPTION t�7'F WORK: 3 C�3 rrao,;1- o c �?,3x 7 -'g4 7X CON5TRUCT'ION I f0'R A UN: 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: 110 Cost of Construction:$ /,��00*- Utilities: —Sewer _Septic Building Height: OW ER lES�SEE: CON CTQR; Name b Name: ,/ c Address: o Company: IV Zit c-C PeflaItt City: � .1 f'......._ ; State:rL Address: Zip Code L�r'�j<</(� �ax'�'' City: �� 1°I-P�' ` Stater Phone No 7 �:% / / I' Zip Codey�Cl 51 Fax 772.y( l 8i y E-Mail: ...,. _. . ...... ,r .-.. . Phone No 2 Z� f' f •,.... Fill in fee simple Title Holder on next page(if different E-Mail o a 3 Ma from the Owner listed above) State or County License 3 D069 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. S.UF�EN A!.C®NSTRFIJ01 l.I 'N i.AUV I' FORMATICI 1: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLETITLEHOLDER: _,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 jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/Lessee/C ctor as Agent for Owner Signature of Contractor/Licensedg:6der STATE OF FLORI STATE OF FLORI COUNTY OF COUNTY OF The forgoing instpirnyipnt was acknowledged efore me The forgoing instr nt was icknowledged before me this day of 20by this day of 20a by 11117 ' - - Name of person making statement. Name of persoiYmaking statement. Personally Known OR Produced Identification Personally Known OR Produced Identification' Type of Identi 'ca Type of Iden [c-at�i Produced C.-- Produced L7� (Signature of N ry Public-State of FI (Signature of oPublic-State of Florida HUMPHREY 14, Commissio 0 W..? R SION17 Commission ��ou "V nomm AUDRESSION#P EY MY Col EXPIRES:March 6,2023 EXPIRES:March 6,2023 P� Off' •FGF F;.• � �, REVIEWS rNT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED lev. 9/26/18