HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q-1
Date: Permit Number:
RECEIVED
Budding Permit Application
Planning and Development Services -? L de County, Permitting_
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT TYPE:
Address: C Pi etC� E( CC
Property Tax ID#:X341-0- ,2( .3- -0'0�3 6 ®b" � Lot No, 01..7
Site Plan Name: Block No. C.
Project Name:
e.--�c mak' ` n -�. 1-,: � -41C.1C U�CA2✓�� cuw�-�
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Additional work to be performed under this permit-check all that apply:
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_Mechanical _Gas Tank Gas Piping _Shutters _Windows/Doors I
_Electric _Plumbing Sprinklers r.Generator Roof sZPitch
Total Sq. Ft of Construction: � Sq.Ft.of First Floor:
Cost of Construction:$- � Utilities: —Sewer _Septic Building Height:
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Name Name: c�4t��
Address: e G Company:)
City:�{sr+ �{ z<cc St e:J�-- Address:1`1 5i,� CS( Cie
Zip Code: Fax: City: pcs C 5Nc L-4C+<- State: 1..
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Phone No. Zip Code: '`f 1 Fax:
E-Mail: Phone No-11 a--X(60-751.S
Fill in fee simple Title Holder on next page(if different E-Mail c O-I
from the Owner listed above) State or County Licenser-C-C-C33 l l-10
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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.
jVIA
AV ,ME
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
i FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: ZFp: 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 thepermit 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
,--�YOLIRAENDER OR AN ATTORNEY BEFORE RECORDING YOUR N TICE OF COMM£N MENTI'
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Sig ature of Owner/Lessee/Contra s Agent for Owner Sign ure of ontractor License Hold
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STATE OF FLORLDA STATE OF FLORIDA j
COUNTY OF COUNTY OF Sir. L JQ
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this�day of-5 V 2NA0_ 20L%J by this��day of Is y\4 20A by 1
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Name of person making state ent. Name of person making stat ment.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of identification Type of Identification
Produced F-L L Produced t_
(Signature of NotaryPublic-State of Florida) nature of Not nlSfiic.,State oftfl+fii )�K'
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_. My coM,�t.." ar 16,2020
�-7 t F,R 2 2 >.. ` F%P1RtiS:.,;e b
Commission No.�Gd a �3 _..- r„ar�4�,oty#GG02 Z o ission No. , �- � 1h3l���icUi�denvai�e��
cr 'a t7lVt.. 2.16. + oer� BG tided
REVIEWS FRONT Z{t�tNG f PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER '��RE1lE�117 REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19