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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c1 Date: I �15�1°1 Permit Number: FnJUL EIVED L 4 - - Building Permit Applicatii2Planning and Development Services Building and Code Regulation Divisionui�Ly, P�rr�rlttlny 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: PROPOSED IMPROVEMsE°NT LOCATION S Address: �t'fiRO-- Lwbllic' s . Iz . Property Tax ID#: 560- W-12 060_ Lot No. Ib Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION O'F'WORK: r t 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 Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ 'Q� �O Utilities: —Sewer —Septic Building Height: OUI/NER/LESS'EE: .; °CONTRACTOR: Name ' Walsh f► Name: Address: !!h S br, Com an l� la ©-� �� a p y: r City:e-703-4 at. L 1t l e, State:Fl e Address: 1016- 1�I,� /d r�/ Zip Code: Fax: City: �'� , i11?rr 6 1 State: F/, Phone No. '?7,� - 5 1-&999 Zip Code: rQ� _ Fax: E-Mail: l i Q I J h 1' Phone No IQ Fill in fee simple Title Holder on next page(0 different E-Mailny-s' mk o oC) en 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. s S1JPPl EMENTAL,CO,NSTRUCTION°'L[EN ,LAW I:NFORMATIO`N =x ; DESIGNER/EN r.. GINEER: 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." Signa re f Owner/Lessee Contractor as Agent for Owner Signa e of Contractor/License Holder STATE 0RID�44 STATE OF FLORD COUNTY OF S'tF• L ,0 COUNTY OF �� L4rr�� The forgoing instrument was acknowledge before me The forgoing instrument was acknowledged before me this�day of—J \ 20 1-1 by this,G day of S �yl 2rn S by — = "' 75 Yah tr `, 11rr•1`, \ yt�t b Y�(+l 09C1 Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identif°iation Produced V fly Produced y JOL- gE1 (Signature of Notar ublic-State of Flori ' ���W� p2zo2� (Signature of Notar. ta � gPa2`�' ���,?� ��:: �};t GP��F.,T. �a�`�puoG�°0 e` �o�s �� .r."°:°"':�''• QM�C�C�E,NSr•�i°n�c`e�t t,all- Commission No. Commission Noi, ;' �, � �:�il :oi Bono REVIEWS FROa�0 SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNt`EVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED R—ev.2/7/19