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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED O(SA A Date: O �vU Permit Number: I t�1 'O(S u►�iw.,d� 6101 9 Building Permit Application Planning and Development Services a3^ D�� Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential — PERMITTYPE: 1('tncaQ PROPOSED IMPR01/EMENT.LOCATION: Address: 30� Ig0k, Cl, r Property Tax ID#: ��'� 3cgdq-, ,3 Lot No. Site Plan Name: Block No. Project Name: DETAILED DEaSC«RIPTION OF WORK: CONSTRUCTI©N IMENEMATI s 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 l Pitch Total Sq. Ft of Construction: J Sq. Ft. of First Floor: Cost of Construction: $ -7,)00 Utilities: —Sewer _Septic Building Height: O NETR/S►Cl aR: Name .59006 a, Name: GU.I c S Address: 125,77' Company: City: 'QOCc& �(��Yl State: , Address: LJ Zip Code: 3 J 3 Fax: City: Fby+-PI e1--CE 'St'ate: Phone Noo 3 Zip Code: 4 . S G Fax: E-Mail: Phone No a O1 GO 9-21 Fill in fee situp a itle Holder on next page ( if different E-Mail f from the Owner listed above) State or County License LCL 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 LAW INFC?RMATI�N: 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. 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 gr 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 LINSPECTION. I ANOATTORNEY BEFORE FRECORDIN CONSULT - NOTICE OOF COMM _ENCEMENT." A� Signatur o ner/Lessee/Contra or as Agent for Owner Signat ntractor/License Holde STATE OF FLORIDA STATE OF FLORI A COUNTY COUNTY OF� �, ,cam The for oing instrument was acknowled o before me The orgoing instr ment was acknowledged before me this day of 20 .k by thi day of 201� by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification -+ Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced : Sign tur of Notary Public-Sta of Florida ) gna ure of Notary Public- ate of Florida.) Commission No. (Seal) Commission No. �t�'r;s.'F;?i' ;�•".,_ 4t GA LASHiA .# RAHMI G MMY CM � 60GG 2750 C �. r ;' EXPIRES: esemIT REVIEWS FROM� - :;F*,40'AJkf 'mNo i e�+riters PLANS VEGETATION SEA TURTLE MANGROVE COUNt REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE _T COMPLETED