HomeMy WebLinkAboutUntitled All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �j Q
Date: 512q I I2 Permit Number:
y , i� t1� �: ,!!! RECEIVED
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Building Permit Appficati`a n 011
AUG 06 2019
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
23000 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)-462-1553 Fax:(772)4:62-1578 Com, mercial Residential _
PERM IT TYPE:
.,R -
Address: ,4 W \Al1ra
Property Tax ID#: 5-) - �� �� '"� V 0`8. Lot No.
Site Plan Name: Block No.
Project Name: , V C Y
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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: 210 P+ Sq. Ft.of First Floor:
Cost of Construction:$ 1900 Utilities: _Sewer _Septic Building Height:
Narne'(V\Q,\�SSC� l�, �.C,hP Name.
Address: �'rt�l D i 1 hl`i►-0� Company:
City:QO Address:
Zip Code• Fax: City: State:
Phone No, `j l 00 2. ZipCode• Fax:
E-Mail:(YV__�e Phone No
Fill in fee simple Title Holder on 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.
Ifvalue.of HVAC is$7,500 or more;a:RECORDED Notice ofCommencement'is required.
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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 todo 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 thafls,granting.a permit will.-authorize the permit'holder to;build the subject structure
Which is in conflict with any applicable Home Owners Assouation rules,bylaw's or and covenants that may restridf'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 usesto another non:residential use
"WARNING TO"OWNER. YOUR',FAILURE TO RECORD;A.NOTICE-OF COMMENCEMENT iMAY_RESULT IN,YOUR PAYING
TWICE. FOR IMPROVEMENTS'TO' YOUR PROPERTY. 'NOTICE OF COMMENCEMENT MUST BE'RECORDED AND
POSTED ON THE.JOB.SITE BEFORE THE FIRST IN5PECTION: IF TOU INTEND TO:<:OBTAIN FINANCING; CONSULT
WITWYOUR LENDER it AN ATTORNEY' y ECORDING-YOUR_?iNOTICEBF COMMENCEMENT."
6-1 - _
Si n : Own r/ ss rector as Age dr;je Signature of Contractor/License Holder
TATE OF•FLORID ) a STATE OF,FLORIDA
COUNTY OF TO COUNTY OF
HE
The forg ing.instrument was acknowledge a 50 The forgoing instrument was acknowledged before me
thisZdayof 20,&b � this day-of 20_ by
Name of person making statement. "_. Name of•person makingstatement.
V
Persona Ily Kbown . OR Produced Identifi Person ally Known OR Produced Identification
Type of Id'entifl ation Type of Identification
Produced Produced
rLuw 0
(Signature of4ota ublic-State of Norida
' . (Signature of NotaryPublic-..State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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