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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED a Date: $������ Permit Number: RECEIVED © AUG14Z19 Building Permit Applicat on Planning and Development Services ST, 6egw- A�ti>y, Par(>littin9 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERM IT TYPE: J a 4, PROPOSED IMP-ROVEMENT',L'OCATION' Address: 6(18% cw;l a 'Of. aQz Property Tax ID#: 3A42- 610-170 -©Oa/ l Lot No. Site Plan Name: ..y Block No. Project Name: ` if DETAILED DESCRIPTION OF WORK , A Ic Chanao QU I.A.-4 �ysE a 5WW CONSTRUCTION INFORMATION:. Additional work to be performed under this permit-check all that apply: -Allechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Sb Cost of Construction:$ L439-4Utilities: —Sewer —Septic Building Height: OWNER/LESSEE., CONTRACTOR: Name (,W(N I )�, 'i h raS net Name: `f6AP1C1SCo �1 r•°t_ Address: Poo( $ Cd.SS)a. -V)f- Company:Qd#,ki+.I Aii of Araw-N City: `to o— I?yne_ State:_fL Address: 67- a VM t m main ?" Zip Code: 340$2 Fax: City: MIFAIMDy State:TL Phone No. 71L 11611- 4423 Zip Code: 93013 Fax: E-Mail: Phone No TUU 7S3 7g1C) Fill in fee simple Title Holder on next page(if different E-Mail Q11altinj aii 6 d�aMef l Mq:k.CU M from the Owner listed above) State or County License CAC MV1 2- 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 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 1 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/%- ENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF INT ND TO OBTAIN FINANCING, CONSULT WITH YOUR LEND R AN NEY BEFORE RECORDING YO R O C O COMMENCEMENT:' O N C ;oY pUB: STEVEN I S M�L r/.' �= Nota,PAN,-qtj to f Florida u e of ner/Lessee/Con or as Aget •r Owner Signa ure C ntractor i rise HolderPQ Commission# G 5564 '?aFfl;f" My Comm,Expirei si 5,2022 E OF FLORIDA STATE OF Rl!ny \ Bonded through Nationa N ary Assn N TY OF I_ COUNTY OF E o rgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me trig i day of hi tt,{LLsk ,2011 q by this day of Pr Lt 1.51 201 k by 7&0— " m Petr Thl�s h��( Mita of person m king statement. / Name of person making statement. Personally Known OR Produced Identification / Personally Known OR Produced Identification Type of Identification Type of identification Produced n Lc<- Produc {Signa of No Fy Public S to of lorida) {Signature of Not P! Ic-State F rida) Commission No. (Seal) Commission No./z ( eal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.