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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: rl 13, 1 `� Permit Number: :z_ ---- � - .` _ Building Permit Applica ion ST. Luittifl Planning and Development Services __ Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: PROPOSE© I�MPR01/EMENT LOCATION: rr Address: e r1�L- PropertyTax ID#: /,(/�/��l'i j� D b_3D b O O - Lot No.,50) Site Plan Name: Block No. Project Name: D TAILED O&SG•RIPT AM OF WORK: �e. x. A ' p� yu K-10 q00qrC'1AF CONSTRUCTION I 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:$�2(2� Utilities: —Sewer _Septic Building Height: OWNER/LE�SSI?E: CONTRACTC�J►R: Name Q, ICi Name: Address: mpany: City: .or �r��y �.� State:� Address: Zip Code: 2VgJf Fax: City: State: Phone No. _ Zip Code: Fax: E-Mail: a 1, .0. A 144 Phone No Fill in fee simple Title Holder Q next page(if different E-Mail 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. 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'w&k 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 kwill,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 MATTORNE Y BEFORE RECORDING-YOUR NOTICE OF COMMENCEMENT." Signature o Owner/Lesse /Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA V,�- O_JL COUNTY OF_Sir. Loc�'z COUNTY OF The forgoing instrument was acknowled ed before me The forgoing instrument was acknowledged before me this 3\ day of_:%\�j 2 ' by this day of 20_ by C.\i,w c 1� �F'�sc.l�bd►c 11 Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifi ation Type of Identification Produced L- Produced (Signature of Notary iblicAM.'e of Fl�ku�lNOAM)WEGIVENS _d E�� .(Signature of Notary Public-State of Florida), ° MY COMMISSION 9 GG 022.02.0 I:1 Commission No.vG EXP, bRocember16,2020 `3e Commission No. (Seal) Bonded ihru ldotz;y f�ublic lJ��;lanrrite;s ;� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION , SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW' REVIEW ' REVIEW DATE RECEIVED DATE COMPLETED ev.