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HomeMy WebLinkAboutBuilding Permit i All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 ( o Date: August 1st,2019 Permit Number: 1 I iq'�So D Building Permit Application 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 X Residential PERMIT TYPE:Demolition PROPOSED IMPROVEMENT LOCATION: Address: 9675 Range Line Road, Port Saint Lucie, Florida 34987 Property Tax ID#: 4201-113-0001-020-9 Lot No. Site Plan Name: 9675 Range Line Road Block No. Project Name: 9675 Range Line Road DETAILED DESCRIPTION OF WORK: Selective demolition Rp ym O U��r,_ 2 A E l e~c1 T1 r-221�_ tk0-.Q I/�TV/ur�(il 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:$ r , ©��< /&Z� Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Liberty Tire Recycling Name:C.G.Taylor Address:P.O. Box 2189 Company:L.E.B. Demolition&Consulting Contractors, Inc. City: Pittsburgh, Pennsylvania State:_ Address:7 Harbour Islde Drive East 204 Zip Code: 15230-2189 Fax: City: Fort Pierce State:FL Phone No.614-604-2038 Zip Code: 34949 Fax: 772-461-2225 E-Mail:rdouglas@libertytire.com Phone No Office 772-461-4545/772-216-1286 Fill in fee simple Title Holder on next page(if different E-Mail iwreckn@aol.com from the Owner listed above) State or County License CGC1519945/27215 :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 i SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: " DESIGNER/ENGINEER: x 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 BEFOR E FIRST INSPECTION. IF YOU INTEND TO OBTAIN . CING, CONSULT WITH YOUR LENDgRv2_AN,&Trqj#NfY BEFORE RECORDING YOUR NOTI F COMM XNCUMENT.7 i Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF salntLucie COUNTY OF segMuxie The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 1st day of August ,20_ by this ist day of August .20_ by Name of person making statement. Name of person making statement. Personally Known xx OR Produced Identification Personally Known xx OR Produced Identification Type of Identification Type of Identification uced ulNi Produced ` 1 al11»Paeo,,� \ I �u (Signature of Notary Public-State oi; '�ssioN''•.,O,p��i ( ignature of Notary Pu ic-State` 'ssioN''•.'c0 'c,G�`pp,��GH 15,?'°i 15, °ip•.'PO Commission NO. GG083308 = eSl� �ciN'� COmmi55ion NO. GGOs3308 •�A ' eal� ?o�'�`ir•• Q•.O/ �b�•Q� % •O 0. i .di e0 J •t0. Q O •� REVIEWS FRONT Zd�ll i !Aub"� V PLANS VEGETATION SE bb(Ir d� \ COUNTER IRE UB' �� REVIEW REVIEW RE .,�, un DATE irin IIIIIN��� �i��Nii1 nlaN��xv RECEIVED DATE COMPLETED ev.