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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: o - Building Permit Application Planning and Development Services �9300 uilding and Code Regulation Division Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential 1PERM IT TYPE: jPROP`OSED-IMPROVEMENT LOCATION Address: /^IAjazz lris _ Property Tax ID#: 3y D Ll2, ©0 - Lot No. J� Sjte Plan Name: PG /ni Block No. Plroject Name. DETAILED DESCRIPTION OF WORK. &-r- TX 7 !/aI11 �aai�odC c��� 1✓t S� I� I CONSTRUCTION INFORMATION: Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters V Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq.Ft of Construction: Sq. Ft.of First Floor: o-m Cost of Construction:$ Utilities: _Sewer _Septic Building Height: I OWN ER/LESSEE; 'CONTRALTO/R: Name L,4 ,r/a1 Wa /1a Ge Name:, Ree g Address: allif A1,e seA_ i er✓ Company: WG 6 e. nouc f+s CCC City: r4_ 191 eC Cz State: L Address: Tl7(,54L) S, .- .du e e-& Zip Code: 3 c(gc-2 Fax: City: Pam+- �54. 1-a Lr e State:�' C Phone No. yZl- Zip Code: Fax: E-Mail: Phone No77Z- ZD 2 53 6� Fill in fee simple Title Holder on next page(if different E-Mail J'g9���yedoor�P�cts��O�hoo C from the Owner listed above) State or County License 3,�937!F( 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 SUPPLEMENTAL CONSTRUCTION LIEN L W INF`ORMATIOW 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 Appli 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. StI. 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. Inl consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work inf accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments. T 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 "I ARNING 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." Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Con ctor/License Holder STATE OF FLOR STATE OF FLOW COUNTY OF `--«Cie COUNTY OF �LCC� The forgoing instrument was acknowledg-1 before me The forgoing instrum nt was acknowledg before me this� day of ` 20-I by thi��day of �K,,, 20) by Name of person making statement. Name of person making statement. Personally Kno� OR Produced Identification Personally Know(;:'\ OR Produced Identification of Identification TVne of Identification Prod rod c Sign ture of Notary Public-Sta., ,,,R Florida WRAIMARAMOS (Signa ure of Notary Public=S �Y MORAIMItR 2i: f MY COMMISSION#GG156738 //���� l�—I s Y PU Commi N C�S�`� ?z� (`�CPBFR-04T31,2021 Commis ' Nd`A� �J al 'YI`'°€ MY( SSION#GGi56f3B Bonde&through 1st State Insurance � '�� 21 38ndthrough at CT 31,20surance REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7 1 i i I