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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: og D/ 9 Permit Number: pzb J^. • . SF ��//j `eo 9 I Building Permit Application `LC/6"ON Planning and Development Services 4nry PAF Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential PERMIT TYPE: PROPOSED IMPROVEMENT LOCATION: Address: 6��/��,e/Q /�V/v D� Property Tax ID#: 7��^� �`'` x`16-1 •6O1•deoa.oQa - -� Lot No. Site Plan Name:�jo�� A`� l/ILGf�S Block No. Project Name: DETAILED DESCRIPTION OF WORK: ft'cm 7�rsTiyG S/li�Gles v Ige x2a%•�f -1Y.0711,612G -Pan1,44-e 1908) 71ate o T /T/a ��2a12) LT�S G o D CONSTRUCTION INFORMATION: 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 5 02- Pitch Total Sq. Ft of Construction: d /�S Sq. Ft. of First Floor: Cost of Construction:$ � Utilities: —Sewer —Septic Building Height: OWNERAESSEE: CON T'RACT®k-"1- NameC AL 131___itJYA Name:;�`/�l I`�y=T CtJlG� Address:J�?�I~: l�oP 4)Z CompanyAfi©��J5'1 .v/lG /g'doFl Co07, City: jie State:f/- Address: Zip;:Code:_ "�J/ Fax: City: r��j P/ yy�L State:7-D Phon'e:No. 7p� '"���� ��o� Zi Code: �3 71�F� Fax: -- p E=Mail: Phone No 3/- J` Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License 3 12,Y 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 I I ' � I ir SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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. 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." 1� Signature Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FUMMA-TeX0.S STATE 0FF I AR+BA le_XCS COUNTY OF I �e��G� COUNTY OF mc-Lerr\0.n The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this -ZLQday of ,t,c r� 20%Ck by this Zl� day of LL(le- 20 till by LaCLc Pricer 1.,c�c Pc-;ce- Name of person making statement. Name of person maring statement. Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification Type of Identification Type of Identification � � Produced D' " l-�CkYISe Produced �s^iyPcs L, cense_ ``���I111111111lI/II�j�' 0%%U11111,1111/1 j/ .�```��Pc\\l A. PAGcS' I. `�� ARY pq�S i AV c �'•, ( '��-tom •'oc c:�••. 00 (Signature of Notary u lic-State of�di) cn : (Signature of Notary P c-State of Florict • n•' Commission No. ��$58�1 X31-1 = `� ' *' ?858-11Q3U i ( SOF( P�y ommission No. Sea} �OF . 04 X82• � V . x28587• REVIEWS FRONT ZONING ���ilR PLANS VEGETATION SEA TURTLE IGfAt( p1i COUNTER REVIEW IEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED - DATE COMPLETED ev.